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DIGESTION AND DYSPEPSIA. 



WOBKS BY THE SAME AUTHOR. 



Hydropathic Encyclopedia, $4 

The Hygienic Hand Book, - 2 

Sexual Physiology, 

Uterine Displacements, 

Colobed Plates, - 5 

I'hboat and Lungs, 

Digestion and Dyspepsia, - 1 

Mother's Hygienic Hand- 
book, - 1 

A Set of Six Anatomical 



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and Physiological Plates, $20. 



Digestion and f) 



IGESTION AND tJYSPEPSIA 



COMPLETE EXPLANATION 

OF THE 

PHYSIOLOGY OF THE DIGESTIVE PROCESSES, 

WITH THE SYMPTOMS AND TREATMENT OF 

DYSPEPSIA 

AND OTHER 

DISORDERS OF THE DIGESTIVE ORGANS. 



ILLUSTRATED. 






BYR. TV TRAIL, M.D., 



Author of "The Hydropathic Encyclopcedia, ' "Hygienic Hand-book," "The 

True Healing Art," "The Bath, its History and Uses,* 

" Hydropathic Cook-book, ■ etc. 



NEW YORK: 
PUBLISHED BY S. R. WELLS & CO., 

737 BROADWAY. 

1875. 










Entered according to Act of Congress, in the year 1873, 

By SAMUEL R. WELLS. 

In the Office of the Librarian of Ccr.gress, at Washington. 



ORPHANS STEREOTYPE FOUNDRY — CHURCH CHARITY FOUNDATION, BROOKLYN. 



CONTENTS. 



I»A^IiT I.-DIGESTION. 

Chapters Page 

Preface ♦ . , 5 

Introduction 7 

I.— Nutrition II 

II. — Insalivation 13 

III.— The Teeth 19 

IV.— Deglutition. . .. 34 

V. — Chymification 35 

VI.— Chylification 43 

VII. — Intestinal Digestion 45 

VIII. — Absorption of the Nutrient Elements 56 

IX. — Aeration of the Food Elements 59 

Tobacco-using 64 

Tight Lacing 68 

Position and Malposition 74 

I^nT n,-DY8PEPSU. 

X. — Nature of Dyspepsia 82 

XI. — Special Causes of Dyspepsia 86 

XII. — Symptoms of Dyspepsia 94 

XIII.— Dyspepsia and the Cachexies no 

XIV.— Principles of Treatment 1 14 

XV.— Food 115 

XVI.— Drink 120 

XVII. — Exercise 122 

XVIII.— Bathing 127 

XIX.— Clothing 132 

XX.— Sleep 136 

XXL— Ventilation 139 

XXII. —Light 143 

XXIII. — Temperature 144 

XXIV.— Mental Influences 146 

XXV.— Occupation 149 

Appendix 155 



PREFACE. 



THIS work, now offered to the public, is a Summary of the 
data which I have been collecting for more than a quarter of a 
century, with regard to the nature, causes, complications, and 
proper treatment of the diseases of the digestive organs ; and 
an experience of more than thirty years, during which time I 
have had the professional management of several thousands of 
invalids (besides hundreds which I have treated through corres- 
pondence), a large proportion of whom were dyspeptics, has 
convinced me that the theories advanced and the practice 
recommended in this volume, are true and successful. I have 
only to add, that I have not in any case administered medi- 
cine, but have relied exclusively on Hygienic agencies as 

remedial resources. 

R. T. T. 
Hygeian Home. i 
Florence Hights^ N, J. J 



INTRODUCTION, 



We are a nation of dyspeptics ; and if we can believe the evidences of 
our senses and the testimony of physicians, we are growing worse continually. 
Where is this devitalizing tendency to end ? There are writers and book- 
makers enough on this subject, but, unfortunately, our anti-dyspeptic litera- 
ture, like the remedy it recommends, is more extensive than useful. Many 
books have been written by physicians, regular and irregular, to advocate 
some favorite theory or hobby, or commend some plan of medication in 
which the author had a professional or pecuniary interest. And a still 
greater number of both have flooded the country with no other motive on 
the part of their proprietors, than to enhance the sale of some nostrum in 
the shape of some " Nervous Antidote ;" " Blood Food ;" "Bitters;" 
"Tonic ;" " Hypophosphite, " or Anti-disease Mixture. All of the litera- 
ture extant calculated to instruct the people in the proper methods for pre- 
venting dyspepsia, and enabling them to treat themselves when sick, with- 
out employing the doctor or patronizing the drug shop, is exceedingly lim- 
ited ; and even that little has an extremely limited demand. 

The public mind has been so long accustomed to rely on medicine to 
remove the penalties of transgression, when persistent disobedience to the 
laws of health has resulted in disease, that remedy and " apothecary stuff " 
have come to be regarded as "one and inseparable." It is a delusion, 
however, which has ruined more than one of the nations of the earth, and 
which is now insidiously but not the less surely undermining the stamina 
of the American people. 

" Every one is more or less dyspeptic now-a-days," is a common saying ; 
and. because every one is ailing in this particular manner, it seems to be no- 
body's business, except those who make opportunity of misfortune. It 
should be the first business of all. It should be the first business of the 



8 INTRODUCTION. 

Christian, the philanthropist, the statesman, the legislator, the schoolteacher 
and especially the physician ; for a dyspeptic race never did and never will 
permanently maintain any progressive government, or liberal institutions, 
or reformatory measures, if indeed they can do anything except relapse 
into barbarism or slavery, as have the nations of old. 

The mortality of dyspepsia makes no alarming exhibit in our "vital 
statistics." So much the worse ; for the causes of constitutional det.ine 
are overlooked. The dyspeptic person has an ever present predisposition 
to almost all forms of chronic disease. Indeed the dyspeptic condition is 
usually regarded as a mere symptom of some other malady, which receives 
the nosological name, and to which the death is accredited. 

In the mortuary statistics of the city of New York, for the last year, dys- 
pepsia is not mentioned as the cause of the death of a single one of the 
32,647 deaths. But the fearful record appears under other names. The 
fact that the increased mortality of 1872 over that of 187 1 reaches the enor- 
mous figures oi 5,500, is conclusive that something is operating among us 
like a continual pestilence, predisposing to a multitude of diseases, and 
rendering the system powerless to overcome their special causes. 

Dyspepsia is the condition that almost always precedes consumption ; in- 
deed, it may be said to constitute its strongest and most prevalent predis- 
position. Dyspepsia in early life, and consumption in middle life, stand 
to each other in the relation of cause and consequence. More than three- 
fourths, and probably seven -eighths, of all the consumptives in adult life, 
were dyspeptics in youth. 

It is an important fact that nearly all affections termed scrofulous and 
tuberculous are due essentially to that kind of Cachexia whose more prom- 
inent manifestations are symptoms of indigestion. Imperfect nutrition is 
the very essence of the long catalogue of chronic diseases which are said to 
consist in a "depraved habit of body," "plethora," "anaemia," scrofula, 
scurvy, and other morbid diatheses. 

The deaths in New York, in 1872, of scrofulous and tuberculous affec- 
tions, are put down at 6,023 5 consumption alone gives us the learful figures 
of 4,274. Then there are 3,479 deaths credited to that mythical phrase, 
"disorders of the nervous system," nearly all of which are the sequelae 
of impaired digestion. We have here a record of nearly fourteen thousand 
deaths attributable to diseases intimately connected with indigestion, and 



INTRODUCTION. 



which could never have existed, certainly not to a fatal degree, without its 
prior existence. But if we were to pursue the analysis through the whole 
catalogue, we should be obliged to add several thousand more to our list of 
deaths essentially due to dyspepsia. Diseases of the liver and kidneys, 
gastritis, enteritis, heart-diseases, bronchitis, many cases of pneumonia, 
most cases of apoplexy and paralysis, and a majority of bowel complaints — 
cholera, diarrhoea, dysentery, colic, constipation, gall stones, intestinal 
concretions, worms, &c, and nine-tenths of the cases of convulsions in 
children, have their predisposing causes and all their dangers, aside from 
medical treatment, in that condition of defective or depraved nutrition to 
which the term indigestion is applicable, and to which it usually is applied 
in the generic sense. 

If we take New York as the basis of a calculation for our whole country, 
the result is frightful ; and sufficiently alarming if we discount fifty per- 
cent, which would render our figuring within the range of probability, if 
not of certainty. It would give us a national mortality of nearly one mil- 
lion, and a mortality attributable to dyspepsia of nearly half a million. 

One thing is certain. The American race must arrest its dyspeptic ten- 
dency, or die out. The Irish, the German, and other foreign races, of 
nerve, stomachs and muscle, and of more ability to maintain vitality in 
themselves and transmit it to offspring, will ere long possess the land, un- 
less our devitalizing habits are reformed. Already some of our older States 
are in decadence in this respect, the births not equalling the deaths. And 
the general repugnance of American wives to become mothers is more 
attributable to the general dyspeptic condition which unfits them to t*. 
mothers, and renders maternity painful and perilous, than to all othey 
causes combined. 




ABBOR VIT.E. 



PART I. 



CH APTER I. 
NUTRITION. 

Nutrition is tne aggregate of all the organic processes. It 
may be distinguishable into digestion and assimilation. Dis- 
integration is the separation and expulsion of the debris, or 
waste matters of the structures. Digestion, in the proper sense 
of the word, means the preparation of the food for assimilation. 
It comprehends insalivation, solution, chymification, chylifi- 
cation, and aeration. A brief exposition of the Physiology of 
Nutrition, in the order of the digestive processes, will the better 
enable us to understand the disorder of the same processes, 
which constitutes indigestion or dyspepsia. And to make the 
subject more intelligible to the non-professional reader, let us 
take an article of food, an apple, if you please, and trace it 
through all of its changes from the tree which produces it, to 
the tissue which assimilates it. 

But, in order to understand the illustrations, the reader 
must steadily keep in mind a few propositions which are fun- 
damental, and which, except the last three, are in direct an- 
tagonism with the doctrines taught in the text-books of our 
medical colleges. These are : 

I. All the actions and cnanges of living organisms are vital, 
not chemical. There is no chemistry in living structure. Hence 
all attempts to explain the problems of life by chemical data 
must forever be fallacious. ■ 

II 



12 DIGESTION. 



2. In the relations between dead and living matter, the liv- 
ing acts on the dead. Hence medicines do not act on the 
living organs or structure in virtue of inherent or elective affin- 
ities, as is taught in the works on Materia Medica and Thera- 
peutics, but, on the contrary, are resisted and rejected by the 
living organs and structures. Nor do poisons act on the 
living system, as is taught in the works on Toxicology and 
Medical Jurisprudence, but contrariwise, the living system acts 
in relation to them. 

3. Diseases are not entities, nor processes necessarily inim- 
ical to vitality, nor materials nor forces at war with the vis 
medicatrix natures, as taught in the works on Pathology, but, on 
the contrary, all diseases are remedial efforts, whose object is the 
defence and purification of the vital organism, and the repara- 
tion of the deranged structures. 

4. Food, drink, air, and other "Hygienic agencies," are in 
no sense "stimulants/' as taught in the standard works on 
Dietetics ; nor do they in any sense act on or do anything to 
the living organs, as taught by the chemico-physiologists ■ but, 
on the contrary, they are acted on by living structures. 

5. Neither medicines nor foods possess any " properties" 
which they impart to the living structures, as is taught in all of 
our medical schools, with a single exception ; but on the con- 
trary, they possess inorganic elements and organic compounds 
which are rejected or appropriated by living structures. 

6. Poisons are those agents which are rejected from the vital 
domain (emetics, cathartics, tonics, stimulants, narcotics, etc. ), 
and foods are those substances which are usable in the forma- 
tion of the bodily structures. 

7. The vegetable kingdom feeds only on inorganic or cnem- 
ical elements in a state of solution, transforming them into 
organic products, or proximate elements, which proximate 
elements, as combined in the processes of vegetable growth, 
constitute food for animals and man. 

8. Animals and men cannot feed on inorganic or chemical 
elements, these invariably being to them in the relation of poi« 



INSALIVATION. 1 3 



sons, nor can any organism, except that of the vegetable, 
produce food of any kind. Hence animals that eat other 
animals can only get such aliment as they have received from 
the vegetable kingdom. 



CHAPTER II. 

INSALIVATION. 

The first act of digestion, after prehension, or taking the 
food into the mouth, is mastication. The object of mastication 
is msalivation. Every particle of food should be mingled with 
saliva, or digestion cannot be properly performed. And here, 
in the outset, we see one of the most prolific sources of disease in 
"high civilization" — imperfect mastication. As meals are 
presented at ordinary tables, and in all hotels and boarding- 
houses (except a few of those which are called Hygienic), 
very few dishes are in a condition to secure mastication, or that 
even admit of chewing ; while the few which might be masti- 
cated more or less, are hurried into the stomach, or washed 
down with milk, tea, coffee, water, or some kind of alcohol- 
ized or otherwise medicated fluid. Those who would have 
perfect digestion should not drink anything at meals. Drink- 
ing should always be done before, after, or between meals. 

Many physicians, and some Hygienists of loud pretensions, 
are very fond of milk themselves, and very fond of recommend- 
ing it as a leading article of food for all enfeebled conditions of 
the digestive organs — dyspepsia, liver complaints, nervous debil- 
ity, consumption, etc. — and even in fevers. And some of 
them seem to be "obsessed" with the chemico-physiological 
phantasy that milk, like fish, is a peculiarly phosphorizing ali- 
ment, and hence marvellously conducive to brain-tissue and 
mental power. 

But such advice is always bad. Many patients can survive 
it, and many will improve in spite of it, provided the sum total 
of all their other habits have been changed for the better. 



14 DIGESTION. 



Milk cannot be among the better articles of the dietary for 
adults in any case. Why ? They do not masticate it. 

It is true that milk, when pure and normally produced (I do 
not mean the commercial article), contains all the nutrient 
elements that the various structures require ; but, unless insa- 
livated, it cannot be properly elaborated and assimilated. 
How well it can be used depends, of course, on the more or 
less healthy condition of the digestive organs. With some it 
seems to agree very well ; and the same may be said of much 
worse things. With others it disagrees very decidedly, and in 
all bad cases of dyspepsia, consumption, or biliousness, it in- 
variably aggravates. It is also especially pernicious in all of 
those complicated and obscure cases of indigestion to which 
the phrase, nervous debility, is usually applied, as I have 
demonstrated in many hundreds of cases. 

It is said in reply to these objections to milk as an article of 
diet for persons after the period of infancy, that nursing 
children, and the young of all mammalia thrive on it, that they 
eat almost nothing else until near the " weaning-time." Ad- 
mitted. But infants take it "the natural way." They masti- 
cate it. They eat it. They do not drink it. They take it drop 
by drop and insalivate it particle by particle, as it flows from 
the mother's breast, or from the nursing bottle when this is 
properly adjusted. If the milk is swallowed too fast, as will be 
the case if the mother uses too much slop-food, or drinks 
largely of tea or coffee at her meals, or if the nursing bottle has 
too copious a delivery, or if rapidly fed with a spoon, the 
child will throw it up ; and if this habit is long persisted in, the 
miik will ferment more or less, the child have a sour stomach, 
flatulence, acrid eructations, canker in the mouth, etc. In a 
word, ' ' the dear little fellow " will be a miserable little dyspep- 
tic. The same things will occur if the child inherits, because 
of the erroneous dietetic habits of one or both parents, a debili- 
tated or imperfect condition of the digestive organs, rendering 
the secretion of the saliva and gastric juice deficient in quantity 
or depraved in quality. Obstinate constipation, chronic diar- 
rhoea, erysipelatous eruptions, bilious humors, scalled head, etc. , 



INSALIVATION. 1 5 



are among the affections which are frequently congenital and con- 
stitutional, because of the dietetic errors of those whose sacred 
duty it was to transmit to them a sound organization — or none. 
I would have no objection to pure milk as an article of food 
for adults, provided they masticate it. But this is never done. 
The adult always drinks it, and never eats it. If he takes it 
with solid food* bread and milk, for example, the fluid or milk 
is swallowed (drunk) before the bread is masticated (eaten), v 
or the whole is bolted down unmasticated together. It would 
be impossible, or at the least very awkward for ' ' children of a 
larger growth," to take milk as infants do. What young lady 
or gentleman would not regard it as a huge joke, or a down- 
right insult to be presented, at a restaurant, with a glass of milk 
and a straw or glass tube through which to suck it, as though 
it were a ''brandy smasher," or a minified glass of soda water? 
Nearly all adults who use milk at meals, sip or drink it as they 
do water or other liquids. 

The practical rule deducible from these considerations is, 
that all kinds of food which are only semi-solid, or composed 
of solid particles diffused in water, as puddings, stews, mushes, 
gruels, soups, etc., should always be taken with dry bread, 
hard cracker, green apples, or something similar, and eaten 
very slowly. The common practice is the reverse ; the more 
fluid dishes are spooned down as rapidly as the process of de- 
glutition can be performed, and the solid material, more or 
less masticated, hurried after it. 

The disease termed Mumps {Parotitis) is an inflammation 
of the parotid glands ; and when both are affected at the same 
time, the mouth is very dry ; mastication cannot be performed 
without pain, nor can the "sensible properties " of food be 
recognized as in the normal state. If strong acids are then 
taken into the mouth, as vinegar, a peculiar benumbing sen- 
sation is experienced. Those who use tobacco, alcohol, or 
condiments excessively, have a condition of the salivary 
glands not unlike chronic parotitis. 

We will the better appreciate the importance of the insali- 



i6 



DIGESTION. 



vation of our food if we notice the ample provision that nature 
has made tj ensure it. 

Fig. i. 




In Fig. i. all of the salivary glands are represented in their natural situation. 
i. The Parotid gland, extending from the zygomatic arch of the cheek-bone to the 
angle of the jaw below. 2. Its duct, termed the duct of Steno. 

3. The Sub-maxillary gland. 4. Its duct. 5. Sub-Lingual gland. 

There are no less than six glands appropriated to the work 
of secreting from the blood the indispensable digestive fluid 
termed saliva ; two parotids, situated one on each side of the 
head, above the articulation of the lower jaw and near the 
phrenological organ of alimentiveness ; two sublinguals under 
the tongue, and two submaxillary, between the others. One 
of each of these glands is represented in the illustration, Fig. i. 

The location of the salivary glands shows their intimate 
relation to mastication, as well as to the perception or recog- 
nition of alimentary substances. The proximity of the two 
large parotid glands to the organs of alimentiveness explains 
why the "mouth waters" instantly when a luscious peach, or 
a basket of ripe strawberries (with or without the cream) 
comes within the range of vision ; and the near proximity of 
the other salivary glands to the tip of the tongue, explains why 
savory substances in contact with that organ, so readily excite 
a flow of saliva. Again, they are all so distributed as to be 



INSALIVATION. 



excited to action by all the hiotions of the tongue and jaws, 
when in the act of mastication. 

That the salivary secretion is sufficient for moistening all 
food that it is proper to swallow, is proved by the fact that no 
true Hygienist ever experiences any thirst while eating ; and 
no one who has a normal secretion of saliva, and who tho- 
roughly masticates his food, will ever desire to drink at meals, 
provided the food is of proper material, properly cooked, and 
not improperly seasoned. It is true, however, that high 
seasoning of all kinds, all indigestible admixtures, and all 
thirst-provoking condiments, necessitate a corresponding degree 
of water-drinking while eating. But this is only on the prin- 
ciple of the lesser of two evils. 

Fig. 2. 

The provision for moistening and 
insalivating the milk on which chil- 
dren may properly subsist, is well 
shown in Fig. 2, which is a repre- 
sentative of a single lobule of the 
parotid gland of an infant, inject- 
ed with mercury, and magnified 
fifty diameters. 

Lobule of Parotid Gland. 

One of the great and increasing evils of imperfect mastication 
is decaying teeth. It is a law of all vital organisms that every 
structure or part must do its own work or die. If a hand or 
an arm was not exercised it would soon perish. Every organ 
and structure pertaining to individual life, that is not duly ex- 
ercised, will be correspondingly enfeebled. Do we not have a 
sufficient, as well as a sad illustration of this subject in the tens 
of thousands of dentists ; in several dental colleges, and in the 
immense establishment in Philadelphia for the manufacture of 
artificial teeth, to say nothing of the instruments for pulling the 
rotting teeth out, which are a part of every country physician's 
outfit ? 

In a majority of cases, the teeth of our fast-living Americans 
begin to decay in childhood. A young lady or gentleman 
with a sound set of teeth is an exception to the general rule. In 




1 8 DIGESTION. 



thousands of instances the young man or young woman needs 
a set of artificial teeth before he or ghe is ready for the mar- 
riage relation. And if both parents are teethless in early life, 
the prospectus den/a/us is bad for the rising generation. 

If the teeth were properly treated they would never decay. 
There is no more reason, except abuse, why the teeth should 
ulcerate or become loose, than there is for the fingers or toes, 
or the ears or nose, to rot and fall off. The teeth are the 
densest, firmest of all organic structures, and should be the 
very last, instead of the first, to decay. 

Domestic animals that are permitted to live normally never 
have decaying teeth. No matter to what age the animal lives, 
its teeth will be found perfect in the skeleton. And such would 
be the case with every human being if the teeth were not 
abused by non-use. 

It ought to be known to all, as it is known to those who 
have lost their teeth, or a part of them, that a whole set of 
sound teeth is as essential to comfort as it is to health. Nothing 
but thorough mastication, and complete insalivation can enable 
one fully to realize the properties of food. All proper food is 
pleasant to the unperverted taste, and the palate relishes it with 
a zest proportioned to its own integrity, and the fineness to 
which chewing reduces it into molecular particles. Those whose 
teeth are too tender to masticate solid food well, or have not 
teeth enough remaining to do it, have little idea of the taste of 
an apple, a potato, or even a piece of bread, made of nothing 
but wheat-meal and water. They require salt, vinegar, pep- 
per, sugar, butter, or something else, to make their victuals 
" taste good." But no amount of salines, acids, or pungents 
can render it so delicious and satisfactory as natural appetite 
and proper mastication ; nor is there any remedy for decay'ng 
teeth, rotting jaws, bleeding gums, and tartareous excrescences, 
except exercising the teeth in mastication. 

This whole subject is so well explained and illustrated in the 
Science of Health for August, 1872, that, with the permission of 
the publisher, I transcribe the en lire article. 



THE TEETH. 



*9 



CHAPTER III. THE TEETH THEIR USE AND CARE. 

Persons who have any pretensions to culture and refinement, 
regard the teeth as ornamental, as well as useful. Before 




Fig. 3. — Complete Set of Permanent Teeth, Showing the Nervous Connections. 

In this illustration the bony matter has been carefully cut away to show the roots of 

the teeth and the nerves which connect them with the brain. 

the age of dentistry, the loss of a tooth by decay was a life-long 
misfortune. Now, if one or more of the teeth decay or by 
accident are broken and lost, skilful dentistry supplies by arti- 
ficial means those which match the original, and the mouth is 
kept shapely and beautiful. 

Within the last thirty years, the science and art of dentistry 
has made very great progress. Not only can the teeth be 
treated in such a way as generally to preserve them, but when 
they commence to decay, the cavities can be so prepared and 
filled that they last or promise to last a lifetime ; whereas, half 
a century ago, decay once commencing would go on, causing 
intense suffering to the patient and an early loss of the tooth. 

We often regret to see persons with excellent sets of teeth 
permit them to remain without being cleaned, the particles of 



20 



DIGESTION. 



food being allowed to lodge between them and decay, creating 
corrosive acid, which destroys the enamel, besides greatly de- 
praving the odor of the mouth. 

Every person, after eating, should carefully clean the teeth 
from all particles of food with a quill or wood pick, and then, 

Fig. 4. — Diseased Teeth. 




Fig. 4 — Represents the jaws, with several of the teeth in a diseased state. Some 
portions of the bony matter have been removed in order to exhibit the parts affected. 
All the teeth which are numbered, except No. 3, which is entirely sound, are carious, 
the disease having penetrated to the nerve. Nos. 1, 4 and 7 show the jaw and teeth in 
an early stage of disease. Nos. 2, 5, 6, 8 and 9 are ulcerated at the roots. Nos. 2, 5 and 
9 having the bony matter removed to show the ulceration at the roots. No. 5 shows 
the ulcer in an early stage 



THE TEETH. 2 I 



with water, not very cold, and a brush, clean them carefully. 
In this way many a set of teeth could be kept sound and hand- 
some through life, which by being neglected become diseased 
and decay early. Some people pick the teeth with a penknife 
or with a pin, which we think an erroneous practice. The 
use of hot drinks, and on the contrary, ice-water in hot weather, 
tends to the decay of the teeth, because it produces a fever, 
and sudden changes in the system, which seriously affect 
them. 

Disease of the teeth appears in several forms. One is by 
caries or decay from the surface. Another is by ulceration at 
the root, and a third is by tartar, which displaces the gum and 
leads to the decay or absorption of the bony matter, constituting 
the sockets of the teeth, called alveolar process. 

The remedy for tartar is to have a skilful dentist remove 
it as soon as it is observed. Indeed an examination should 
be made by him occasionally to detect its presence. Proper 
care of the teeth by the use of a brush after every meal would 
generally prevent all accumulation of tartar. 

These conditions we illustrate by means of several en- 
gravings. 

The Indians are proverbial for their good teeth. We have 
examined many Indian skulls and have frequently found the 
teeth worn down to the gums with not a speck or decayed spot 
to be found on them. Besides, we do not find on Indian 
teeth tartar, or salivary calculus, as is too often the case with 
civilized men's. There may be many reasons why the teeth of 
Indians are in better condition than the white man's. The 
chief one perhaps is, that they give their teeth ample exercise. 
If a cow is fed on food that requires no mastication, her teeth 
become decayed. If she crops the grass with her incisors, 
and grinds it with the molars, they will last her life-time in good 
condition; but let her be put into a stable and fed on still-slops, 
and the teeth at once begin to decay, as also the bony structure 
in which they stand. The Indian eats parched corn. Having 
no grist mill, he grinds his food with his teeth, and the result 



22 



DIGESTION. 



is, every tooth is exercised. If we eat porridge, broth, stews, 
and everything else cooked softly, and get no exercise for the 
teeth, they become to us almost useless ; the gums become 
unhealthy, the teeth decay, and give us a world of trouble. 

Moreover the Indian sleeps with his mouth shut, breathes 
through his nostrils, and does not draw the cold air rapidly over 
his teeth. This is true of all animals. The canine and feline 
tribes, that pant when they exercise violently, open their 
mouths and breathe through the mouth ; but they sleep with 
their mouths shut. White men sometimes breathe the live- 
long night chiefly through the mouth. The celebrated Mr. 
Catlin, who writes on Indian habits, attributes bad teeth to the 
white man, in consequences of sleeping with his mouth open. 




Fig. 5.— Complete Set of Infant Teeth at Four Years. 

. Jways beware of using scouring material on the teeth. A 
little fine soap on the tooth brush, to make a pleasant lather 
in the mouth, is believed to be favorable to the health of both 
mouth and teeth. One half of the tooth-powder have acids in 
them which injures the enamel of the teeth. Any gritty sub- 
stance which tends to wear off the enamel is bad. 

In cities, quack peddlers of tooth-powders may be found at 



INSALIVATION. 



23 



the corners of the streets. They will get some dirty boy's 
mouth open and with strong acid make his teeth shine like 
ivory. This they do as an advertisement. We never fail on 
seeing a crowd of ignoramuses gathered around such a quack 
to speak -frankly to them, and advise them to avoid it alto- 
gether. One of these men once overheard our remark, and 
said "What is it to you?" Our reply was, "We wouldn't 
put such acid on our teeth for five hundred dollars." His 
crowd of customers vanished. 




Fig. 6. — Teeth of a Cow Fed on Natural Food. 

Having exhibited the anatomical situation of a complete 
set of permanent teeth, showing their nervous connections, 
and also a permanent set of teeth in a condition of disease in 
various stages, we come now to consider infantile teeth, and 
introduce an engraving for that purpose. The bony structure 
is cut away on the jaws to show the roots of the milk teeth, as 
they are called, and also to show the ultimate teeth or the 
permanent set behind the milk teeth. 

Before birth the teeth are organized rudimentally, two sets 
of them, one above the other ; and at birth, existing in the 
jaw entirely below its service, there is a set of teeth, and under 
this set there is a little sack, which is to be, when developed, 
a permanent tooth. 

In the engraving one half of twenty teeth are represented. 



24 



DIGESTION. 



In the adult mouth there are thirty-two teeth.- In the rear of the 
mouth of this engraving there will be seen the rudiments of the 
permanent teeth, over which no milk teeth are developed. In 
the child's mouth then there are twenty teeth, and in the adult 
mouth thirty-two, including the wisdom teeth, which come 
late, at from twenty to fifty years of age. 




mm 

Fig. 7.— Jaw of a Cow Fed on Hot Still-Slops. 

The infantile teeth are small, being adapted to the size of 
the jaw. When the child's age advances these teeth separate, 
the jaw grows and the teeth are rendered further apart. If the 
teeth are not extracted soon enough, the permanent teeth 
sometimes push out at the side. This often happens in the 
case of the eye-tooth ; but generally the teeth are lost one 
after another, first on the lower jaw; the jaw expands and the 
cavity of the mouth increases so as to make sufficient room for 
the large permanent teeth. 

The process of cutting teeth is not an unnatural one, and 
ought not to be painful or dangerous. In the present state of 
things, however, children often suffer severely from it, and not 
unfrequently life is destroyed in this way. This, of course, is 
induced by irritation and feverish excitement, which is con- 
nected with the brain by means of the nerves of the teeth; the 
same amount of pain might be sustained by the patient without 
injury, if related to the foot or hand and farther away from the 
brain. 

The bad habit of feeding children cake, sugar and candy, 



INSALIVATION. 25 





Fig. 8.— Tartar on Foul Teeth Tartar Removed. 

is often the cause which tends to produce much trouble relative 
to the teeth, especially early decay, which is at present so com- 
mon. Our artificial modes of living greatly destroy the natural 
order of development in children, hence it is supposed that the 
trouble with the teeth is the result of ages of wrong courses of 
living. The death of one half of all the children that are born 
before they come to maturity is a sad commentary on the crea- 
tive wisdom that established the natural laws and punishes the 
bad habits and usages of civilized society. Nature is per- 
fect. God the Creator is all-wise and beneficent. If we were 
but wise enough and good enough to obey the laws of our 
being, this great mortality of children, this falling off of human 
fruit before it is ripe, would be done away with. Mr. Catlin 
asserts that nearly all the infants among the Indians, unless 
they died of accident, came to maturity. Though he saw as 
many as four thousand Indian skulls in a depository of the 
dead, there was not an infant's skull among them. The death 
of infants and children was so rare, that the oldest inhabitants 
had to study to recall the death of children, except of accident. 
But our children inherit, with the abuses of civilization, bad 
conditions of the teeth generally from parents who have lived 
in an abnormal way ; hence the great trouble with cutting the 
te*eth, and with their early decay after they are cut. 

A full set of false teeth, in the upper jaw at least, is very com- 
mon among women of twenty-five and among men of thirty- 
five in our own country to-day. Occasionally we find one of 
the old stock who retains a healthy and vigorous set of teeth 
until he is seventy years old, without a speck of decay, with 
the ranks all full. This law of temperance and health, of 



26 DIGESTION. 



sound constitution and sound teeth with long life, pertains to 
the animal kingdom as well as to men. 

The cow's jaw, (Fig. 6, ) shows every tooth in its place and 
order, with a fine enamel, adapted to do the work for which 
they are designed ; and when these teeth are used in the natu- 
ral way they are healthy, and we may safely conclude the ani- 
mal is throughout in like healthy condition. But when we 
turn to the under jaw of the cow that has been fed on warm 
still-slops and kept housed up — even as women and children 
often are — secluded from wholesome air, we find the teeth de- 
cayed and the bone of the jaw unhealthy, and we have a right 
to infer that the whole animal is in a similar unhealthy condi- 
tion. 

The illustrations of tartar which we present, show a very 
common neglect in taking care of the teeth, and though the 
teeth themselves may not be decayed, the bony socket which 
contains them decays, and sometimes the teeth, lacking sup- 
port, fall out and are lost. 

One of the best evidences of good culture and proper care of 
one's self, is a tidy mouth and nicely kept teeth. Every reader 
knows some person who, when he laughs, presents teeth that are 
covered with tartar, or blackened by smoking, and whose 
mouth is a disgust to every beholder. Such people should go 
to a mirror, where they can take a view of their open sepulchre, 
full of dead or unclean bones. 



The lowest forms of animal life have the simplest digestive 
apparatus, and subsist on such kinds of food as require little 
elaboration. The very lowest animals that we can trace seem 
to be all stomach, all the processes of digestion being performed 
in a single canal or cavity. No animal ever manifests two 
organs or structures, or parts, without one of them being ana- 
logous to a stomach. The monera, the lowest form of animal 
life yet recognized, has, apparently, no organs, parts nor struc- 
tures. When it needs food it projects an instrument and takes 
it into its substance. Yet it has a digestive apparatus, or it 
would not live, develop, grow, nor'divide into parts, nor differ- 



INSALIVATION. 



27 



ential into organs. The digestive organs of fishes and reptiles 
are comparatively simple. Birds macerate the grains and seeds 
in their crops, and then masticate them in the stomach. The 
gizzard, a tough muscular substance, lined with an exceedingly 
dense membrane, capable of grinding stones, metals, and even 
glass to impalpable powder, performs the office of teeth. 

In the carnivorous quadrupeds the' stomach is much smaller 
and the alimentary canal much shorter than in the herbivorous, 
while the omnivora have an intermediate size of stomach and 
length of intestines. The lower jaw of the carnivora has 
only the up-and-down, or cutting motion, while the teeth are 
adapted to tearing the flesh on which they subsist, as seen in 
the cut, Fig. 9. 

Fig. 9. 

In the omni- 
vora, of which 
the hog is un- 
fortunately our 
most familiar 
example, the 
back teeth have 
a close resem- 
blance to those 

JAWS AND TEETH OF A PANTHER. 

of herbivorous animals, while the front teeth exactly re- 
semble the tearing and dagger-like teeth of the carnivora, as 
represented in the cut, Fig. 10. 

Fig. 10. 





UNDER JAW AND TEETH OF THE HOG. 



28 



DIGESTION. 



The masticating organs of the camel, which subsists on the 
coarsest herbage, show a much stronger resemblance to those 
of carnivorous animals than do those of the human being ; and 
hence, if we are to judge the natural dietetic character of man 
from the standpoint of comparative anatomy alone, we must 
place him at a farther remove from flesh-eaters than is the 
camel. It can hardly fail to be noticed by the attentive reader 
that the irregular arrangement of the teeth peculiarly fit the 
animal for munching and breaking up the branches, sprouts, 
stalks, etc. , which constitute a large proportion of its food. 

Fig. ii. 




eating, 



JAW AND TEETH OF THE CAMEL. 

The articulation of the lower jaw also admits of the lateral, 
rotary, and grinding motions, as with all grass-eating, grain- 
and fruit-eating animals. 

FlG - I2 - In the jaw of the horse, Fig. 12, the in- 

cisors, or cutting-teeth, are placed in front, 
to enable it conveniently to crop the grass 
and other herbage ; and the grinding-teeth, 
for mashing and comminuting the food? 
occupy the back part. There is no trace 
whatever of tearing, or carnivorous teeth. 

In the orang-outang, Fig. 13, which is 
a purely frugivorous animal, the articula- 
tion of the jaws admits of the grinding 
motion. In some of the monkey tribes, the baboon for 
example, the cuspids do resemble the corresponding teeth of 
the carnivora ; they are not, however, used for flesh-eating, but 




SKULL OF THE HORSE. 



INSALIVATION. 



29 



seem to be an arrangement which serves them for weapons of 
offence or defence. 

The distinctions of the human teeth are seen in the illustra- 
tion, Fig. 14. The incisors (I) are intended for biting and 
cutting the fruits, nuts, grains, or whatever may be his proper 
food ; the cuspid or corner-tooth (C), sometimes called canine 



Fig. 13. 




JAWS AND TEETH OF AN ORANG-OUTANG 

from its resemblance to the corresponding tooth of the dog, 
enables him to grasp more firmly and retain more securely the 
alimentary substance ; and the bicuspids (B) and molares (G) 
which are the small and large grinders, are fitted to mash and 
comminute all solid kinds of food. 

The following communication to the Science of Health, by 
Mrs. Fannie R. Fendye of Baltimore, Md. , may fittingly con- 
clude this branch of our subject, premising, however, that it is 
not ' ' betel-eating " but better mastication and fewer unhygi- 



30 DIGESTION. 



if J A 



Fig. : 

/k 




HUMAN JAW AND TEETH. 

enic habits which make the contrast between Oriental and Oc- 
cidental teeth so unfavorable to us — realizing the dream of 
Giles Corey, who was pressed to death for the crime of witchcraft 
in " Salem Town " some two hundred years ago : 

"I saw a man pull all his teeth — 
It took him but a minute ; 
He oped his mouth and put them back — 
I thought ye deuce was in it." 



THE TEETH AMONG DIFFERENT NATIONS. 

" In all the cities of south-eastern Asia I found not a single 
dentist, with the solitary exception of one in Calcutta. And 
even he, I think, has since retired for want of employment, 
and gone home in disgust — resolved, henceforth, to live among 
people sufficiently 'civilized' to destroy their own teeth and 
wear artificial ones instead. This paucity of supply must indi- 
cate a want of demand ; as it is unquestionably true that the 
ranks of the dental profession are ever increasing — the colleges 
of our own country alone sending out regularly graduates 
enough, it is said, to supply the world. In India there are 
merchants, lawyers, clergymen, physicians, druggists, soldiers, 
sailors, teachers, and mechanics, both native and foreign. 
Only dentists are lacking, and the reason is because they are 
not needed. 

' ' Everybody has fine teeth in the East. I have seen both 
men and women, at ninety, with perfect teeth, and seldom one 



INSALIVATION. 3 1 



under fifty who had lost a single incisor or cuspid, and perhaps 
not even a molar. 

"Two European gentlemen, aged respectively twenty-six and 
thirty, were one day conversing with a young Siamese noble, 
who remarked that he could never guess the age of foreigners, 
as they looked so different from natives. The younger of the 
two then said, ' What do you imagine my age to be ?' 
'About nineteen or twenty, I suppose/ was the reply. 
'But really, I think you look even younger/ 'Well, but 
see here, ' said the foreigner ; ' I have lost a tooth, ' pointing 
far back in his mouth to the place from which one of his ' wis- 
dom-teeth ' had recently been extracted. ' Have you, 
indeed?' asked the noble, manifesting great concern — 'then 
you must be eighty or ninety. I did not think you were so 
old/ 

"The late king of Siam, who died at the age of sixty-five, had 
a set of teeth that our proudest belle would have gloried in — 
except the color, for he always had them painted black — the 
Siamese, in common with most oriental nations, deeming 
white teeth a vulgarity. Paint for the teeth is in the East as in- 
dispensable an article of the toilet, as powder and rouge for 
that of a French woman. Even young ladies with pearly teeth 
so exquisitely beautiful that it would seem sacrilege to mar 
their gleaming whiteness, will, as soon as they become of age, 
— that is, ten years old, after which they are considered marriage- 
able — commence staining the teeth, first red, and afterwards 
jet black, and. so they are worn through life. But this is by no 
means to avoid the trouble of keeping the teeth in neat condi- 
tion ; for, as a general rule, orientals take far more care of the 
teeth than do most western nations. 

"Toothache is, I think, utterly unknown in the East, except 
among white foreigners, as I do not remember to have found 
a single case among the natives. Certainly there must be some 
cause for this marked exemption from diseases of the teeth. It 
may be due, in part, to the constant use of the betel or arica-nut, 
which all classes and both sexes, in nearly every part of India, 
chew all day long. They combine with the betel, chunam, 



32 DIGESTION. 



pepper-leaves, and fine-cut tobacco — little trays containing these 
various ingredients of the popular quid, standing about in 
every apartment, ready to be offered to honored or wzlcome guests, 
the moment they are seated. Not to offer it, is deemed a lack 
of hospitality, or an intimation that the visitor is not received 
as an equal ox friend. Eating betel is in Southern and Eastern 
Asia, just what eating salt is in Western Asiatic countries — a 
token and bond of perpetual friendship, that not even a rogue 
or a murderer would violate. Those who have once partaken 
together of the ' betel quid, ' are thenceforth sworn friends, till 
death sunders the compact. The arica is highly astringent, like 
the nut-gall ; and from this quality may tend, in some mea- 
sure, to the preservation of the teeth. Another cause is, 
probably, found in the extremely regular habits of all classes 
in regard to meals, with which nothing is allowed to interfere. 
When dinner-time comes, an oriental dines, whether he is at 
leisure or not ; and he would do so, I think, if a beleaguering 
foe were thundering at his gates. But between meals they never 
eat. Such habits in regard. to eating, cannot fail to be pro- 
motive of the general health, and, of course, the teeth share the 
benefit. A still more potent cause is, I think, the fact that 
orientals never take either food or drink, very hot or very cold. 
Ice is unknown in most parts of the East, and none but for- 
eigners, or those who have learned it from them, make any 
attempt to find a substitute for ice, by artificial cooling pro- 
cesses. Tea and fruit juices are the beverages most in favor ; 
the former taken without cream or sugar, and only moderately 
warm ; while the latter are used just as they are expressed from 
the fresh, ripe fruit. How absolutely opposite to the habits of 
nearly every American, at home or abroad ! It is said by those 
who have taken pains to inform themselves on the subject, that 
there is no country in the world, civilized or savage, where bad 
teeth are so generally the rule, and good ones so rare an excep- 
tion, as the United States. And there is probably no other 
nation who so generally swallow tea and coffee hot enough to 
scald the throat, and then 'cool off' by an immediate draught 
of iced-water. An Englishman would regard such a habit as 



THE TEETH. 33 



absolutely suicidal, and he is amazed that sensible Americans so 
recklessly jeopardize health and life. At English hotels, people 
can, of course, have whatever they demand and pay for, as at 
public houses elsewhere ; but in private families in England, 
even the wealthy, the use of ice is only moderate and occasional 
— not by any means the constant, every-day, excessive affair it 
is with us ; and there it is never taken immediately after hot drinks, 
as at breakfast and supper among Americans. Neither do 
English people eat irregularly, and at all hours between meals, 
as do many of our countrymen — a practice by which the diges- 
tive organs must become impaired and the general health 
suffer, even if the teeth did not. . 

" Another deleterious practice, common in our large cities 
especially, is the excessive use of ice-cream and soda-water. 
Nothing is more common on summer evenings, than for young 
people to swallow, at their boarding-houses, a cup or two of 
coffee boiling hot, and as rapidly as if they were drinking for a 
wager, and then to rush out for an ice-cream or glass of soda, 
"to cool off with " — the "fruit syrups '" of the soda water often 
containing " fusil oil " and other poisons, apart from the delete- 
rious effects on the teeth of these extremes of heat and cold 
following each other in quick succession. A distinguished 
flentist told me recently, that it was difficult to conceive of any- 
/ thing more absolutely destructive to the teeth than the simultaneous 
\ use of cold and hot drinks. And he added that he had known 
scores of Europeans, who came to the United States with teeth, 
that, with the habits of living to which they had been accus- 
tomed at home, would probably have lasted to extreme old 
age — glad, in less than five years after they came amongst us, 
to avail themselves of the services of a dentist to manufacture an 
artificial 'set/ 

"Surely something may be done, to avert this wide-spread 
curse of toothache and discolored, uncomely teeth, or the only 
alternative that remains of wearing those not ' to the manor 
born ;' so that Americans of future generations, at least, may 
cease to enjoy the enviable distinction of belonging to a 
toothless nation" 



34 



DIGESTION. 



CHAPTER IV. 



DEGLUTITION. 




Fig. 15.- 



-A View of the Roof of the Mouth and of 
the Soft Palate. 



1. The Roof of the Mouth, bounded by the Superior 
Dental Arch. 
The Soft Palate. 
The Velum Pendulum Palati. 

4. The Ridges seen on the Roof of the Mouth. 

5. The Tubercle behind the Incisor Teeth. 

6. The Middle Line of the Hard Palate. 

7. Orifices of some of the Mucous Follicles. 
The Tonsil. 

9. The Pharynx. 

After the food has been properly masticated, it is to be swal- 
lowed. The next process, therefore, is deglutition. And it is 
worth a moment's delay to consider the ample, if not wonderful 
contrivances for effecting the passage of the food from the 
mouth to the stomach, without the artificial aid of drink. 

On each side of the mouth, at the commencement of the 
Phaiynx (back part of the mouth), is a glandular organ, termed 
Tonsil, whose office is to furnish a lubricating fluid. This is 
shown in the cut, Fig. 15, 8. In addition to these glands, 
the whole mucous surface exhales a moistening and lubricating 
fluid, more refined than any oleaginous matter ever produced 
by artificial means, that used in sewing machines not excepted. 
This secretion is formed in tubes, called Mucous Follicles, the 
orifices of some of which are shown at 7. Persons who use 
very hot drinks, and irritating condiments, or strong alkalies, 
sometimes have a thickening of the mucous membrane of the 
oesophagus, which renders deglutition difficult. 
11 



CHYMIFICATION. 35 



CHAPTER V. 

CHYMIEICATICXN". 

The second stage of digestion, in the processes of the trans- 
formation of the food elements into living structure, is termed 
chymification. This is performed in the stomach. The older 
physiologists regarded digestion in the stomach as analogous to 
fermentation ; modern authors are very discordant in their 
opinions of the nature of the process, some regarding it as 
mainly mechanical, and others as purely chemical. The sim- 
ple truth is, it is a vital process, as are all other processes per- 
taining to living organisms. 

In the stomach the food is mingled with a solvent, called the 
gastric juice, whose wonderful properties have thus far eluded all 
chemical and microscopical investigations. It is known to be 
slightly acid, and to have a power of transforming organic ele- 
ments unlike that of any other known substance. It is said, 
also, to " digest" inorganic, and even metallic substances, 
Which have been purposely or accidentally swallowed ; but this 
opinion is certainly an error, for oxidation, or decomposition, 
which is all that can happen to them in the gastric cavity, is a 
very different process from digestion. 

A general view of the abdominal organs is represented in Fig. 
16. The adipose matter in the chest has been removed, as has 
the Greater Omentum, which covers the viscera in front. The 
liver also has been turned back to exhibit its under surface and 
the Lesser Omentum. 

It will be noticed that the stomach is nearly semicircular in 
shape, concave above and toward the liver on the right side, 
convex toward the spleen on the left side, and that its main 
bulk is on the left of the median line. The stomach, heart, 
and spleen are all chiefly on the left side, a provision which 
seems necessary to counterbalance the largest glandular organ 
of the body, the liver, which is situated on the right side. A 
knowledge of this arrangement of the organs enables us to un- 
derstand many of the complicated and obscure pathological 



3* 



DIGESTION. 




Fig. 16. 
i. The gread Blood-vessels. 2. The Lungs of each side. 3. The Heart. 4. The 
Diaphragm. 5. Under surface of the Liver. 6 The Gall-Bladder. 7. Union of the 
Cystic and Hepatic Ducts to form the Ductus Choledochus, which empties the bile into 
the Duodenum immediately below the pit of the stomach. 8. Anterior Face of the 
Stomach. 9 The Gastro- Hepatic, or Lesser Omentum. 10. Gastro-Colic, or Greater 
Omentum, cutoff to show the small intestines, it. Transverse Colon, pushed a little 
downwards. 12 Its ascending portion, also pushed down. 13. Small Intestines. 14. 
The Sigmoid Flexure of the Colon. 15. Appendicula Vermiformis. 

conditions resulting from congestion and enlargement of the 
liver. When congested, its very weight causes a painful, drag- 
ging sensation in the vicinity of the stomach, and when very 
much enlarged it causes the body to bend to one side, especially 
in young persons, often resulting in double curvature of the 



CHYMIFICATION. 37 



spine. I have known several children who were badly incur- 
vated, attended in some instances with partial or complete 
paralysis of one of the lower extremities. And I have known 
such patients treated for months with tonics, showering, elec- 
tricity, ' ' movements," and some worse things, without benefit:, 
and without any suspicion on the part of the attending physicians 
of the real nature of the difficulty. In other cases its pres- 
sure against the stomach would cause much distress in that 
organ, especially after meals. In still other cases its upward 
pressure against the diaphragm would cause continual diffi- 
culty of breathing, occasioning short breath, coughing, and 
palpitation, whenever the patient would step hurriedly, or walk 
up-stairs, often resulting in severe asthmatic paroxysms. 
These patients can never be cured, as the reader will readily 
understand, until the diseased condition of the liver is pro- 
perly attended to. 

The relation of the stomach to the great blood-vessels below 
the heart, enables us to explain many strange and often frightful 
sensations with which all dyspeptics are more or less familiar. 

The illustration, Fig. i 7, represents the stomach and oesopha- 
gus in their natural position, and shows the proximity of the 
stomach to the descending aorta and other large blood vessels of 
the abdominal cavity. The thoracic viscera, nearly all of the 
diaphragm, and the intestines, have been removed ; the peri- 
toneum (lining membrane of the cavity of the abdomen) has 
been detached from the kidneys, and the duodenum is left. 

One of the most distressing symptoms of many dyspeptics is 
a hard beating or throbbing behind the stomach. It is gene- 
rally worse soon after lying down, and the throbbing is some- 
times so violent as to jar the whole body and shake the bed- 
stead. Many persons in this condition have apprehended 
" organic disease of the heart," and not unfrequently their 
physicians, unable to account for these occasional tumults of 
the central organ of the circulation on any other hypothesis, 
have diagnosticated ' ' heart disease. " 

A reference to the illustration will make the matter plain 
enough. All dyspeptics have one of four conditions, and 



38 



DIGESTION. 



Fig. 17. 

Stomach and Great Blood-vessels. 

. Upper portion of the (Esophagus. 
Arch of the Aorta. 
Lower portion of the (Esophagus. 
Vertebral Column. 
Vena Cava Ascendens. 
Pancreas. 

The cut edge of the Diaphragm. 
Great Cul-de-Sac of the Stomach. 
Cardiac orifice of the Stomach. 
Pyloric orifice of the Stomach. 
Spleen. 
The Peritoneal Coat of the Stomach 

partially turned off. 
Right Kidney. 

Lower curvature of the Duodenum. 
Ascending Vena Cava. 
Abdominal Aorta. 
A section of the lower bowel (Rectum). 

many all of them. 1. Consti- 
pation. 2. Enlargement of the 
liver. 3. A contracted and rigid 
state of the abdominal mus- 
cles. 4. Congestion of the ad- 
jacent organs — lungs, spleen, 
kidneys and pancreas. Either condition causes obstruction to 
the free passage of the current of blood down the descending 
aorta, and when all co-operate, the effect is extreme. The swol- 
len organs and unyielding muscles press the stomach directly 
against the large blood-vessel, so that ever)' contraction of the 
left ventricle of the heart propels a column of blood through 
the arteries on which the stomach presses, not only causing the 
jarring or throbbing sensation, but actually lifting the lower 
side of the stomach to some extent. The effect is exactly 
analogous to that of moderate blows or rappings against the 
under side of the stomach. If the region around the stomach 
is contracted, as is the case with many "confirmed dyspeptics/' 
or "caved in," as is the case with all women who have laced 
tightly in early life, this pounding symptom is greatly aggravated. 
In such cases the patient, on retiring to rest and assuming the 




CHYMIFICATION. 



39 



horizontal position, will often experience noises in the ears like 
the "sound of many waters/' or the rushing of a cataract. 
This symptom is also always worse soon after taking a full meal ; 
and if such a person take a "hearty supper/' and retire 
immediately to bed, his sensations will be more forcible than 
agreeable ; and his unquiet slumbers will alternate with parox- 
ysms of incubus, preceded by frightful spectres, fantastic situa- 
tions, impossible adventures, and all the goblins of air, earth, 
and sea. 




Front View of the Stomach. 



i. Anterior Face of the CEsophagus. 2. The Cul-de-Sac, or greater Extremity. 
3. The lesser or Pyloric Extremity. 4. The Duodenum. 5. A portion of the Peritoneal 
Coat, turned back. 6. A portion of the Longitudinal Fibres of the Muscular Coat. 7. 
The Circular Fibres of the Muscular Coat. 8. Oblique Muscular Fibres. 9. Portion of 
the Muscular Coat of the Duodenum, shown by removing the Peritoneal Coat. 

The process of chymification means simply the formation of 
the food material into a homogenous, pulpy mass. For this 
purpose it is mixed with the gastric juice and compressed and 
kneaded by the muscles which constitute the middle coat of 
the stomach. The fibres of this muscular coat are so arranged 
as to do their work admirably, as is shown in the illustration, 
Fig. 18, which represents a front view of the stomach, distended 
with air, the peritoneal coat being turned back. 

It will readily be seen that this arrangement of longitudinal, 
circular and oblique muscular fibres allows the stomach to 



40 DIGESTION. 



compress and knead the ingesta in all possible directions, as 
the varied motions of the tongue enable it to move the food in 
the mouth, during mastication, in every direction. 

The active principle, or solvent, of the gastric juice, is evi- 
dently corpuscular, as is, probably, that of all organic secretions. 
A something analogous to this has been obtained from the 
analysis of the gastric juice, and termed pepine ; but pepine 
in the living organism, just as nature produces it, and pepine 
out of the living organism, as the chemist prepares it, are very 
different materials, although the latter does produce a solvent 
effect on alimentary substances. But the idea of introducing 
pepine into the materia medica as a substitute for the gastric 
juice, or as a remedy for indigestion, is as absurd as would be 
the notion of preparing our food in such a manner as not to 
require mastication. Indeed, this latter practice is very general, 
for, do not learned physicians tell us, and eminent physiologists 
explain to us, that bread, for example, when made light by 
fermentation, can be more readily permeated by the saliva and 
gastric juice ? Surely they forget, when treating of dietetics, the 
nature of the physiological function termed mastication. 

The pepine which is employed as a "digester" in medicine, 
is usually obtained from the stomachs of pigs, by scraping the 
mucous membrane with a blunt instrument. In order to pro- 
duce it in large quantities the animals are kept without food 
until their appetites become keen, and then placed where they 
can smell the food without getting hold of it. The smell of 
the savory viands provokes a flow of gastric juice, or of some- 
thing analogous, which is then obtained pure, as is supposed, 
by killing the animal. But, as all organic secretions are modi- 
fied by and partake of the dietetic character of the animal, it 
seems to me that the omnivorous swine, always filthy and 
scrofulous in its domesticated condition, is the worst possible 
source from which to obtain pepine for the human stomach. 
The peptic corpuscles of a scrofulous pig may infect the human 
being with malignant disease, as readily as the vaccine virus 
from a diseased animal produces the worst forms of confluent 
small-pox. 



CHYMIFICATION. 4 1 



The corpuscles of the gastric juice are very tenacious of life, 
as are all similar secretions. In rennet, the dried stomach of 
the calf, they may retain their organic properties for years. 
One of the peculiar properties of gastric juice, is that of coagu- 
lating milk. Dr. Fordyce long ago ascertained that six grains 
of the mucous coat of the stomach, infused in water, will pro- 
duce a liquid that will coagulate one hundred ounces of milk, 
or 6, 857 times its bulk. 

It has been ascertained that a single drop of gastric juice con- 
tains not less than half a million of corpuscles, and that the 
quantity necessary for the proper digestion of a single meal 
may be reckoned in figures at not less than 130,000,000,000 ; 
a number that need not surprise us when we recollect that 
modern scientists have estimated the constituent molecules of 
a drop of water at several billions. 

In a prize essay on Cheese-making, by S. R. Arnold, of 
Lansing, Michigan, published in 1870, the author claims that, 
in the ordinary process of cheese-making, the corpuscles, or 
cells, obtained from rennet, are not destroyed in the cheese, 
but are transferred to the stomachs of those who eat the cheese, 
and may there assist digestion ! 

But this is pushing nature quite out of the universe. If 
cheese, or anything else that contains gastric corpuscles, is 
necessary or useful in the digestive processes of the human sto- 
mach, how are those human beings going to digest their vic- 
tuals who have not cheese or something similar ? And how are 
the animals that never use any pepine except the home-made 
article, to get along ? Old cheese is well known to be one of 
the most indigestible articles that was ever swallowed in the 
name of food ; occasioning constipation of the bowels, canker 
in the mouth, dryness of the mucous surfaces, and deficiency 
in both the gastric and salivary secretions. Says the old dis- 
tich : 

" Cheese is a surly elf, 
Digesting all things but itself." 

Perhaps Mr. Arnold derived his philosophy from this couplet 
of the muse. But it is not truth, whatever may be said of the 



42 



DIGESTION. 




FIG. 19. 

Gastric Glands. 



poetry. It is an unnatural and very unwholesome food ; in- 
deed, it is not food at all in the proper sense of the word, 
though containing certain alimentary proximate principles in 
an altered and degenerated form. Because cheese is a dry 
food, that is, contains little water, some English medical writers, 
in view of the scarcity and high prices of flesh-food, consequent 
on the "rinderpest," "pleuro-pneumonia," and "rot," among 
so many of the cattle and sheep brought to the London mar- 
ket, have recommended cheese as a substitute. They will find 
a much better article of diet in that king of the cereals, wheat, 
provided they know how to cook it hygienically, or in any one 
of twenty grains, fruits, and roots that could be named. 

Another peculiar property of the gastric 
secretion has been called antiseptic. This 
term is not strictly correct, for antiseptic ap- 
plies properly only to dead matter. It is true, 
however, that partially decayed vegetables and 
semi-putrescent flesh, lose all offensive odor 
soon after coming in contact with the gastric 
juice. But this effect results from the trans- 
forming power of the solvent, by which the 
molecular atoms are re-arranged and the fetid 
gases decomposed and dissipated. All that 
an antiseptic can do is to prevent decay by 
rendering the organic elements fixed and un~ 
changeable, as with salt, vinegar, alcohol, 
arsenic, etc. This is why all salted aliments 
are more indigestible and less nutritious than 
those which are fresh. 

In Fig. 20, the entrance to the secreting 
follicles are shown, in the cells upon the 
surface of the mucous membrane of the- 
stomach. 
The mucous membrane is so completely 
studded with glands for the secretion of the gastric juice that 
its surface has a velvety or napped appearance, as represented 
in Fig. 1 9, which is a section of the coats of the stomach near 




FIG. 23. 

Secreting Tubes. 



CHYLIFICATION. 43 



the pylorus, showing the gastric glands magnified twenty dia- 
meters. 

The immediate consequences of a deficient supply of gastric 
juice — a condition that exists with all dyspeptics — are, acidity, 
flatulence, eructations, water-brash, heart-burn, etc. 

After the food has been duly prepared in the stomach in 
the manner we have seen, it is passed through the pylorus 
(lower orifice of the stomach) into the duodenum, the first 
portion of the small intestines. The pyloric portion of the 
stomach and the upper portion of the duodenum are liable 
to become ulcerated, indurated, tuberculated, and even can- 
cerous in persons who have much abused their digestive or- 
gans with strong condiments, indigestible aliments, alcoholic 
liquors, or other poisons. 



CHAPTER VI. 
CHYLIFICATION'. 



In the duodenum the food, now chyme, is mingled with the 
secretion from the mucous membrane of the intestine itself, the 
bile, and the pancreatic juice. Physiologists do not yet agree 
as to the precise offices performed in the organic economy by 
the liver or pancreas. The bile is certainly, in part, and prob- 
ably wholly, an excrementitious fluid, or excretion, although 
being of an alkaline nature, it may incidentally mingle with 
the fatty matters of the food, and by converting them into a 
saponaceous mass, assist in their passage or absorption. All 
physicians are familiar with the various phases of disease which ] 
result from a deficient excretory action of the liver. Jaundice, 
rashes, humors, erysipelatous affections, dimness of vision, 
impaired hearing, and a multitude of cutaneous eruptions are 
attributable to "biliousness." 

The following extract from the author's work, "The Hy- 
dropathic Encyclopcedia, n may be pertinent in this place : 

' ' The liver forms the bile from the venous blood. The ob- 
ject of the biliary excretion evidently is to eliminate certain inv 



44 DIGESTION. 



parities from the body in the form of compounds of carbon, 
hydrogen and nitrogen, and also to deterge the blood of a 
portion of any excess of alkali that may be absorbed by the ve- 
nous extremities. 

1 ' Liebig has fabricated a singularly inconsistent hypothesis, 
which has satisfied himself and all others who are satisfied to 
echo his arguments without taking the trouble to examine 
them, that the bile is a nutritive product, and that, conse- 
quently, whatever will tend to the formation of bile, or any of 
the proximate elements usually found in bile, is a useful and 
nutritive substance. Liebig reasons in this wise : The bile is 
composed of several certain proximate elements. One of these 
is called taurine. This taurine is the only compound or prox- 
imate element found in the bile which contains nitrogen. Now 
theine and caffeine, the active principles of tea and coffee, are 
found, on chemical analysis, also to contain a very small quan- 
tity of nitrogen ; ergo, tea and coffee, though injurious excit- 
ants to the nerves, may be useful to the liver by furnishing 
the nitrogenous element of the taurine of the bile. Such rea- 
soning is extremely absurd, and the error is a most palpable 
one. It consists in mistaking a waste material for an aliment ; 
a depurating process for a nutritive one. As well might one 
mistake putrid flesh for wholesome food, because it contains 
carburetted hydrogen, which is also found in the fceces, or ex- 
crementitious matters of the bowels. " 

The pancreatic juice, mingling with the oily matters of the 
food, or with the food (and it should be stated here that oily 
matters are never digested nor changed in the stomach), redu- 
ces them to the condition of an emulsion, which means, 
dividing the oily particles so minutely that they lose their 
apparent individuality. In this emulsified condition the fat is 
capable of being absorbed and carried into the general circu- 
lation, and, finally, expelled through the various emunctories, 
or deposited in the cells of the areolar tissue. 

The spleen, when enlarged and indurated, is what is known 
in popular parlance as ' ( ague cake. " It is common in malarious 
districts after the intermittent fever has been ''broken up" by 



INTESTINAL DIGESTION. 



45 



large doses of quinine or arsenic. When dyspepsia is compli- 
cated with this condition, the patient is always despondent and 
melancholy, unless the organic or vital temperament exists, 
with a very large development of the phrenological organ of 
hopefulness. 

The relation of the pancreas to the spleen on the left side, 
and the duodenum on the right, is shown in Fig. 21. The 
cut represents the organs as viewed anteriorily, with their 
blood-vessels injected. 




Fig. 21. — Pancreas, Spleen, and Duodenum. 

<$, The spleen. 2. Its Diaphragmatic Extremity. 3. Its Inferior Portion. 4. The 
f«sure for its Vessels. 5. The Pancreas. 6. Its Head, or the Lesser Pancreas. 7. 
duodenum. 8. Coronary Arteries of the Stomach. 9. The Hepatic Artery. 10. The 
Splenic Artery. 11. The Splenic Vein. 



CHAPTER VII. 



ISTTESTmAL DIGESTION. 

From the commencement of the small intestines to the ter- 
mination of the large ones, the mucous lining of the canal 
secretes a fluid which not only smooths the passage of matters 
along its surface,- but aids in the elaboration of the nutrient 
elements. In different portions of the alimentary tract there 
are special glands, follicles, or other secreting structures, aiding 
in the complex process of converting " pabulum ?; into living 
structures. The small intestines are divided by anatomists into 
the duodenum, jejunum, and ileum, and the large intestines into 
the cecum colon and rectum. A glance at some of the more 



46 



DIGESTION. 



prominent of these special appendages to the digestive apparatus 
will not only show how ''fearfully and wonderfully " we are 
made, but may induce us to have a little more compassion on 
our own bowels, if we cannot have "bowels of compassion" 

for others ; for it is in the 
long and tortuous tract of 
the intestinal canal that* 
J the most aggravated mise- 
[ ries of a dyspeptic life are 
I experienced. Choleras, 
colics, diarrhoeas, worms, 
hemorrhoids, various con- 
cretions, and, worst of all, 
constipation, have their 
seat in the intestinal tube, 
in addition to inflamma- 
tory affections and struc- 
tural derangements, which 
are common to all parts 
of the system. 

In Fig. 22, is seen a 
section of the ileum, in- 
verted, so as to show the 
appearance and arrange- 
Fig. 22.— Section of the Ilium. ment of the villi en an ex- 

tended surface, as well as the follicles of Lieberkuhn. The 
follicles are represented by the great number of black points 
between the villi, or proiections, and can only be recognized 
by a close inspection. 

A section of the small intestine containing some of Peyer's 
glands, as shown under the microscope, is represented in Fig. 
23. They secrete a milky fluid with numerous corpuscles of 
various sizes, but not so large as those of the blood. The 
meshes seen in the folds are the ordinary tripe-like folds of the 
mucous coat. 

Several late pathologists have advanced the theory that an 
inflammation of Peyer's glands in the jejunum and ileum, is the 




INTESTINAL DIG ESTION. 



47 




Fig. 23. — Peyer's Glands. 



essential cause of typhoid, or enteric fever, while an inflamma- 
tion of Brunner's glands, in the duodenum, is the essential 
cause of typhus or putrid fever. But these theorists have mis- 
taken effect for cause. In 
some instances these glands 
were found inflamed or dis- 
organized after death. In 
other cases no such appear- 
ances were discoverable. 
If inflammation of these 
glands was the cause of 
these fevers, post-mortem 
examinations should have 
confirmed it in all cases. 

The entire number of 
follicles in the whole ali- 
mentary canal has been 
reckoned by Dr. Horner 
{"Special Anatomy and 
Histology, ") at " forty-six 
million nine hundred thou- 
sand and upwards. " They 
constitute the minute ana- 
tomy of the mucous coat, 
and their most prominent 
phases are represented in 
the four following illustra- 
tions : 

Fig. 24, is a view of the 
follicles of the colon, mag- 
nified one hundred and fif- 
teen times. Their aggre- F ig. 24— Follicles of the Colon. 

gate number is estimated at nearly ten millions. 

Fig. 25, is a view of the folds and follicles of the stomach, 
highly magnified. About two hundred and twenty-five are found 
on every square of an eighth of an inch, which would give a 
little more than a million and a quarter for the entire stomach. 




48 



DIGESTION 



In Fig. 26, are seen the follicles and villi of the jejunum 
highly magnified. As the villi are erected by the injection, 

they run into each other 
and press one upon an- 
other like the convolu- 
tions of the cerebrum. 

The follicles and also 
the villi of the ileum, 
highly magnified, are 
represented in Fig. 2j. 
These villi are curved, 
with their edges bent 
in, or concave. There 
is, however, in the whole 
alimentary canal, al- 
most every conceivable 
form and shape. 

It is in the large 
intestines, where fecal 
matters are liable to 
accumulate, that the 
most distressing ^effects 
of indigestion are man- 
ifested. Admirable as 
are their structural ar- 
rangements and irregu- 
larly curviform direc- 
tion for the performance 

Fig. 26.— Follicles of the Jejunum. of their functions under 

normal conditions, these very circumstances render them liable 
to become the seat of terrible sufferings when obstructed or 
diseased. This fact may be inferred from a glance at the 
illustration, Fig. 28, which is a view of the position and curva- 
tures of the large intestines. 

The large intestines differ from the small in being saccu- 
lated, an arrangement which favors the retention of the nu- 
trient material which has not yet been taken up by the 




INTESTINAL DIGESTION. 



49 




extremities of the veins and the lacteals, until it can be com- 
pletely absorbed, and also facilitates the excretion of fecal 

matters from the blood. 
But if constipation ex- 
ist, these sacculations 
become loaded with 
hardened fceces, and 
sometimes with other 
concretions, rendering 
the patient as miserabk 
as can well be ima- 
gined. 

It will be noticed 
| that the contents of thf 
Fig. 27.— Follicles of the Ileum. large intestines are car- 

ried in a circuitous route, and 
in one place directly upward 
for ten or twelve inches ; thence 
across the abdominal cavity to 
the right side, thence down- 
Iward on the left side to a posi- 
tion below the ileo-ccecal junc- 
|tion ; thence through the sig 
moid flexure (a curvature re - 
sembling the letter S), and 

1. The end of the Ileum. 

2. Appendicula Vermiformis. 

3. The Coecum, or Caput Coli. 

4. The Transverse Colon. 

5. The Descending Colon. 

6. The Sigmoid Flexure. 

7. Commencement of Rectum. 

8. The Rectum. 

9. The Anus.— The Levator-Ani Muscle 
Fig. 28.— The Large Intestines. i s shown on each side. 

finally, downward again in a straight line to the outlet. 

The careless observer might see, in this extraordinary con- 
trivance, nothing but a useless complication that renders the 
whole organism ever liable to manifold infirmities and prema^ 
ture destruction. But a similar mistake has been made with 




50 DIGESTION. 



regard to the convolutions of the brain. There is neither sim- 
plicity nor symmetry on the encephalic surface, and its irre- 
gular elevations and depressions seem, to the non-philosophical 
mind, but a promiscuous and useless massing together of brain 
substance. But the physiologist, and especially the phreno- 
logist, sees the matter with very different eyes. He perceives 
the use, and then recognizes the beauty of the whole arrange- 
ment. He has learned that all of this unevenness of surface 
unfolds and spreads out, so to speak, the mental organs, and 
correspondingly augments their power. 

The last of the small intestines (ileum) opens into a large 
sac or pouch, which is the portion of the large intestine termed 
ccecum. This is very large in some of the herbivorous animals. 
In the horse it is larger than the stomach. The careful student 
may inquire, for what purpose is the little tortuous worm-like 
appendage depending from the lower part of the ccecum ? Well, 
it has no physiological use whatever, and yet, paradoxical as it 
may seem, "nothing is made in vain." Like the little tri- 
jointed bone at the lower extremity of the vertebral column, it 
seems to point a moral. It is the relic of a lower organization, 
and is the strongest argument, perhaps, that can be adduced 
in favor of the doctrine of "Evolution." In some of the 
lower animals, which subsist on coarse food and herbage, the 
beaver, for example, the appendicula vermiformis constitutes 
another pouch or stomach, or a prolonged ccecum. As the 
food becomes more frugivorous and concentrated in the ascend- 
ing scale, the appendage is not needed, and perishes by non- 
use. If the human race exists long enough, and continues to 
develope in its cerebro-spinal tissue, the unseemly excrescence 
will entirely disappear. But I do not wish to be understood 
as interpreting " Darwinism " so as to make man the 
' ' descendant " of the lower organizations. My opinion is that, 
in the order of progressive development he has ascended above 
the whole animal kingdom. 

A view of the whole range of the alimentary canal is presented 
in Fig. 29, A portion of the oesophagus has been removed on 



INTESTINAL DIGESTION. 



51 



The arrows indicate 



account of want of space in the figure. 
the course traversed by the ingesta. 

Fig. 29. 
Alimentary Canal in situ. 
x. The Upper Lip, turned off at 
the mouth. 2. Its Froenum. 3. 
Lower Lip, turned down. 4. Its 
Froenum. 5, 5. Inside of the cheeks, 
covered by the lining membrane of 
the mouth. 6, Points to the opening 
of Steno's Duct. 7. Roof of the 
mouth. 8. Lateral Half Arches. 9 
Points to the Tonsil. 10. Velum 
Pendulum Palati. 11. Surface of the 
Tongue. 12. Pappillse near its point. 
13. A portion of the Trachea. 14. 
CEsophagus. 15. Its Internal Sur- 
face. 16. Inside of the Stomach. 
17. Its Greater Extremity or great 
Cul-de-Sac. 18. Its Lesser Extrem- 
ity or smaller Cul-de-Sac. 19. Its 
Lesser curvature. 20. Its greater 
curvature. 21. Cardiac Orifice. 
22. Pyloric Orifice. 23. Upper por- 
tion of Duodenum. 24,25. Remain- 
der of the Duodenum. 26. Its Val- 
vulae conniventes. 27. Gall Blad- 13 
der. 28. Cystic Duct. 29. Divi- 
sion of Hepatic Ducts in the Liver. 
30. Hepatic Duct. 31. Ductus 36 
Communis Choledochus. 32. Its 
opening into the Duodenum. 33. , fi 
Pancreatic Duct. 34. Its opening 
to the Duodenum. 35. Upper part 
of the jejunum. 36. Ileum. 37. 
Some of the Valvular Conniventes. 

38. Lower extremity of the Ileum. 

39. Ileo Colic Valve. 40, 41. Cce- 
cum. 42. Appendicular Vermifor- 
mis. 43, 44. Ascending Colon. 45 
Transverse Colon. 46, 47. Descend- 
ing Colon. 48. Sigmoid Flexure of 
the Colon. 49. Upper portion of the 
Rectum. 50. Its lower extremity. 
51. Portion of the Levator Ani Muscle. 52. Anus. 

With the anatomical data before us, it is not difficult to 
understand why, in cases of prolonged constipation, or in tor- 
pid and feeble states of the alimentary canal and abdominal 
muscles, the coecal pouch should be the portion of the canal 




52 DIGESTION. 



most liable to obstructions and accumulations. Many persons 
of good constitutions, not conscious of any very bad habits, 
who live "as other folks do," and attend to their daily busi- 
ness, suffer continually of fcecal collections in the ccecum, and, 
generally, to some extent in the colon also, especially in that 
portion of it denominated the sigmoid flexure, without the 
least suspicion of the real cause of their difficulties. And 
physicians of extensive practice and long experience not unfre- 
quently dose such patients for years with aperients, cordials, 
stimulants, tonics, alteratives, nervines, and opiates, and some- 
times with mercurials in addition, with no thought of the nature 
of the troublesome symptoms. I have known several cases in 
which the lower extremities were so feeble and the back so 
weak, from no other cause than the one we are considering, 
that the patients could not walk without a cane in each hand. 

The ordinary symptoms are, a sense of weight or heaviness 
in one or both iliac regions, with occasional dull pains, alter- 
nating more or less frequently with aching or griping sensations. 
Sometimes the sensation in the part will be of a dragging or 
bearing-down character, in extreme cases amounting to a most 
intolerable tormina and tenesmus as in dysentery. All of these 
symptoms may be mild or severe according to the amount of 
excrementitious material present and the efforts made to dis- 
lodge it Diarrhoea may also be present without removing the 
constipation, for the fcecal matters are often so hardened and 
impacted that fluid dejections pass by them without solving or 
moving them. 

Literary and sedentary persons are much more liable to 
obstructions of the ccecum and colon than are laboring persons. 
Clergymen, lawyers and legislators, who devote much time to 
writing or studying, and do not give proper attention to diet 
and exercise, are often extreme sufferers. Were it proper and 
useful to do so, I could give the names of distinguished bishops, 
divines, statesmen, lawyers, and even physicians, who have been 
dragged down from positions of honor and wealth, to moral 
degradation and poverty, because of this condition of their bow- 
els, and the medical treatment. 



INTESTINAL DIGESTION. 53 

I say medical treatment advisedly. The condition itself 
might have occasioned disease and even death. But it would 
not alone occasion dishonor. Opiates were given to relieve 
pain, and stimulants to ' * support vitality. " Their effects were 
only temporary, and as the cause was not removed they were 
frequently repeated. Soon morphine and brandy became 
necessities ; and eventually drunkenness became a habit, fol- 
lowed in some instances by debauchery and other vices. Some 
of the readers of these lines may remember the sad story of two 
distinguished prelates, men of good name and fame and unim- 
peachable piety, occupying the exalted positions of Bishops of 
the two greatest States of our Union — New York and Pennsyl- 
vania. They were brothers. Both were degraded from their 
high and holy office for intoxication and lecherous conduct. 
The unfortunate men were more sinned against than sinning. 
It was shown on their trial that the medicine which had worked 
their ruin had been prescribed by their physicians. 

But, to say nothing of the various entozoa which are frequently 
found in different parts of the alimentary canal, all of which 
are scavengers, and could not exist were it not for the morbid 
secretions and improper ingesta, there is another group of ex- 
ceedingly distressing affections whose seat is the rectum. I mean 
hemorrhoids, or piles. Chronic inflammation of the mucous 
surface is among the effects of prolonged constipation, and this 
may extend from the mucous membrane of the ccecum and 
colon to that of the rectum, or fcecal accumulations may occur 
in the rectum. The result is, the numerous veins in the lower 
part of this portion of the intestinal tube, very near its outlet, 
become distended into tumors, rupture and bleed, or the 
mucous membrane itself becomes disorganized, and portions 
of it are hardened with excrescences and tumors of various 
forms, sizes, and degrees of consistence. In these cases defe- 
cation is always painful, and the pain is sometimes excruciating. 
When these tumors are large or numerous, or the whole 
mucous membrane greatly relaxed, the tender and perhaps 
bleeding bowel will prolapse after each defecation, in many 
instances only to be replaced with difficulty and suffering. In 



54 



DIGESTION. 



extreme cases these tumors are removed by surgery — ligation or 
caustic 




Fig. 30. — Muscles of the Trunk, in Front. 
In Fig. 30 are seen the muscles of the trunk anteriorily. The superficial layer Is seen 
on the left side, and the deeper on the right. 1. Pectoral is major. 2. Deltoid. 3. Ante-, 
rior border of the latissimus dorsi. 4. Serrations of the serratus magnus. 5. Subclavius 
of the right side. 6. Pectoralis minor. 7. Coracho-brachialis. 8. Upper part of the 
biceps, showing its two heads. 9. Coracoid process of the scapula. 10. Serratus magnus 
of the right side. 11. External intercostal. 12. External oblique. 13, Its aponeurosis ; 
the median line to the right of this number is the linea alba ; the flexuous line to the left 
is the linea semilunaris ; the transverse lines above and below the number are the lineae 
transversse. 14. Poupart's ligament. 15. External abdominal ring ; the margin above 
is called the superior or internal pillar ; the margin below the inferior or external 
pillar ; the curved intercolumnar fibres are seen proceeding upward from Poupart's liga- 
ment to strengthen the ring. The numbers 14 and 15 are situated upon the fascia lata of 
the thigh ; the opening to the right of 15 is called saphenous. 16. Rectus of the right 
side. 27. Pyramidalis. 18. Internal oblique. 19. The common tendon of the internal 
oblique and transversalis descending behind Poupart's ligament to the pectineal line. 
20. The arch formed between the lower curved border of the internal oblique and Pou- 
part's ligament, beneath which the spermatic cord passes, and hernia occurs. 



INTESTINAL DIGESTION. 



55 



But the student who would master the complex physiology 
of digestion, should not overlook one important auxiliary which 
is scarcely alluded to in medical books, and not mentioned at 
all, so far as I know, by the standard authors on Theory and 
Practice, in connection with the therapeutics of indigestion. 
I mean the abdominal muscles. There is a good reason why 
the abdominal viscera, and especially the alimentary canal should 
not be enclosed within bony walls, as is the case with the brain 
and the organs of the thorax. The walls of the abdomen are 
formed of muscular and tendinous bands, which are thin, flexi- 
ble, and exceedingly strong. This structure provides for a 
great degree of mobility in the va- 
rious movements of the body, and 
aids powerfully in the peristaltic 
action of the bowels. In the act 
of defecation these muscles, co-i 
operating with the action of the! 
muscular coat of the intestinal 
canal, compress the whole abdo- 
men firmly yet steadily, so that 
the contents of the bowels are 
moved along and expelled easily 
and without pain. But when 
these muscles are inactive, from 
rigidity or relaxation, the whole 
effect is thrown upon the delicate 
fibres of the muscular coat of the 
intestines, resulting in imperfect 
or incomplete defecation, and, 
eventually, torpor and exhaustion 
of the peristaltic action. 

Fig. 31. — Muscles of the Trunk, laterally. 
Fig. 31 is a side view of the muscles of the trunk. 1. Costal region of the latissimus 
dorsi. 2. Serratus magnus. 3. Upper part of external oblique. 4. Two external inter- 
costals. 5. Two internal intercostals. 6. Transversalis. 7. Its posterior aponeurosis. 
8. Its anterior. 9. Lower part of the left rectus. 10. Right rectus. 11. The arched 
opening where the spermatic cord passes and hernia takes place. 12. The gluteus maxi- 
mus, and medius, and tensor vaginae femoris muscles invested bv fascia lata. 




56 DIGESTION. 



Many "wonderful cures" have been effected, of dyspeptics 
who had been dosed and drugged for years unavailingly, by 
simply exercising the abdominal muscles, by methods which" will 
be explained hereafter. 



CHAPTER VIII. 
ABSORPTION OF THE NUTRIENT ELEMENTS. 

The nutritive elements o. the food are taken from the ali- 
mentary canal by the extremities of the veins, and by the lac- 
teal vessels, which originate in the small intestines. The 
process of absorption commences in the stomach and extends 
nearly or quite the entire length of the intestines. The venous 
absorbents convey their contents directly to the mass of blood, 
while the lacteal transport the matters which they take up 
through the mesenteric glands to the receptaculum chili, whence 
they are emptied into the blood near the heart 

In the stomach the more watery portions of the aliment, and 
such elements as require little elaboration, are taken up by the 
extremities of the veins. When milk is taken the watery part 
is absorbed and the solid portions reduced to a coagulum, or 
curd, before gastric digestion can take place. The lacteal 
absorbents convey the more dense and oleagenous elements, 
termed chyle, which is usually of a milky white color; but 
this depends much on the quality of the ingesta, being nearly 
transparent in those who use little or no fatty matters in or with 
their food. 

A provision for the further -elaboration of the chyle is found 
in the mesenteric glands, which are convolutions of the absorb- 
ent vessels numerously distributed along their course. 

Fig. 32 is a view of the beautiful arrangement of these chyle- 
carriers. They are represented as injected. The arteries of 
the jejunum and mesentery are also injected. 



ABSORPTION OF THE NUTRIENT ELEMENTS. 



57 




Fig. 32. — Lymphatics of Jejunum and Mesentery. : 



1. Section of the Jejunum. 

2. Section of the Mesentery. 

3. Branch of the superior 
Mesenteric artery. 4. 
Branch of the superior Me- 
senteric Vein. 5. Mesente- 
ric Glands receiving the 
Lymphatics of the intestines. 

The structure and 
arrangement of the 
mesenteric glands 
are better shown in 
Fig. 33, which is a 
view of the lympha- 
tics as they appeared after death of abdominal dropsy. 

1. Thoracic Duct. 2. Sec- 
tion of the Aorta. 3. Glands 
around the Aorta which receive 
the Lymphatics from the intes- 
tine and give off vessels to the 
Thoracic Duct. 4. Superficial 
Lymphatics on the intestine. 
5, 5. More Lymphatic glands 
receiving vessels from the in- 
testine. 6, 7. Lymphatics from 
the intestine and mesentery. 

All of the muscles 
of the abdomen are 
auxiliary to respiration 
as well as to digestion. 
Indeed they constitute 
the chief forces in the 
act of expiration ; and 
without they are main- 
tained in a vigorous condition by appropriate exercise, neither 
breathing nor digestion can be well performed. In the act of 
vomiting the spasmodic contraction of these muscles is the main 
force that ejects the contents of the stomach, and in the various 
forms of cholera and diarrhoea, it is mainly the same force, ab- 
normally exerted, that causes the evacuations. Hence it becomes 
as necessary to regulate the action of these muscles in fluxes 
Smd profluvia, as to invigorate them in cases of dyspepsia. 




Fig- 33. — Mesenteric Glands. 



58 



DIGESTION. 



The course and termination of the Thoracic Duct, and its 
relations, are represented in Fig. 34. 

Fig. 34. — Thoracic Duct. 
1. Arch of the Aorta. 2. Thoracic Aorta. 3- 
Abdominal Aorta. 4. Arteria Innominata. 5, Left 
Carotid Artery. 6. Left Sub-Clavian Vein. 7. 
Superior Vena Cava. 8. The two Veins termed 
Venae Innominatae. 9. Internal Jugular and Sub- 
Clavian Vein at each side. 10. Vena Azygos. 11. 
Termination of the Vena Hemi- Azygos in the Vena 
Azygos. 12. Receptaculum Chyli ; several Lympha- 
tic Trunks are seen opening into it. 13. The Thora- 
cic Duct, dividing opposite the Middle Dorsal Verte- 
bra in two branches, which soon re-unite ; the course 
of the Duct behind the Arch of Aorta and Left Sub- 
Clavian Artery is shown by a dotted line. 14. The 
Duct making its turn at the Root of the Neck and 
receiving several Lymphatic Trunks previous to ter- 
minating in the Posterior Angle of the Junction of the 
Internal Jugular and Sub-Clavian Veins. 15. Ter- 
mination of the Trunk of the Lymphatics of the 
Upper Extremity. 

What precise changes the chyle un- 
dergoes in passing through the mesen- 
teric glands is not known, but as all 
glands are secreting, excreting, or 
elaborating organs, it is certain that 
the influence they exert on the nutri- 
tive fluid is important ; hence it is 
essential to perfect digestion that these 
minute and complicated structures are 
not deranged nor impaired. And just 
here is another consideration of no small importance. It is 
said by some medical authors, that when mercurial and other 
mineral drugs come in contact with the mesenteric glands, they 
"take on" inflammation. The phrase is absurd, but the 
meaning intended to be conveyed is, the medicine or poison 
(as it is administered with therapeutic or homicidal intent), 
occasions inflammation of the glands ; and the rationale is, the 
vital structures, recognizing the presence of an enemy within 
the vital domain, resist or oppose it by determining the blood 
to the part. The inflammatory process, however, although it 




ABSORPTION OF THE NUTRIENT ELEMENTS. 59 

retards, does not prevent the passage of the drug ; for, as it is 
necessary for the chylous fluid to be passed along, the mineral 
particles which, in the form of oxides, chlorides, or salts, are 
exceedingly minute, pass along with it. The glands may be 
permanently diseased in this matter, and this method of getting 
drug-medicines into the blood is always more or less damaging 
to these delicate structures, and is the origin of most of the 
tumors which are seated in the mesentery, and which are be- 
yond the reach of medication or surgery. In some cases hun- 
dreds, and in other cases thousands of these glands are involved 
in the formation of an indurated irregular tumor and sometimes 
occupying a large portion of the abdominal cavity. If invalids 
must have their blood and tissues pervaded with the agencies 
of the drug shop, the safer way is to administer them hypoder- 
mically. By injecting them into the skin they will pass directly 
into the blood, and thus save the wear and tear of the digestive 
organs. When repeated doses of potent drugs are sent into the 
circulation through the long and devious route of the digestive 
apparatus, the effect is not unlike that of the march of an 
invading army through an enemy's country. If the aggressive 
forces put on their best possible behavior, they are enemies still, 
and more or less desolation will mark their track. And in view 
of the fact that we kave, in the United States, thirty thousand 
drug shops, and seventy-five thousand physicians, furnishing 
the supplies and prescribing the doses, it may be a fair question 
for a debating lyceum, whether there is more dyspepsia pro- 
duced by drug medication than by all other causes combined ? 



CHAPTER IX. 
AERATION OF THE EOOD ELEME35TTS. 

But the processes of digestion are not completed until the 
nutrient material reaches the lungs. In the respiratory organs, 
it receives its finishing elaboration, which fits it for assimilation. 
And here is another consideration for dyspeptics which is sel* 



6o DIGESTION. 



dom sufficiently regarded, if, indeed, it is ever thought of. 
No food can be assimilated unless properly aerated. Each particle 
of food must come in contact with a particle of atmospheric air, 
or it can never be used — else it is worse than useless. For this 
purpose it is diffused through the lungs with the blood which 
is there decarbonized. All of the venous and lacteal absorbents, 
as we have seen, convey the nutrient matters which they take 
up from the stomach and small intestines to the right side of 
the heart, as do all the venous extremities and lymphatics which 
originate in the large intestines. From the right side of the 
heart it is conveyed, with the venous blood from all parts of the 
system, to the lungs. 

The function of aeration is not fully understood. It is well 
known that in respiration the blood is purified of its effete car- 
bon, and that oxygen is received into the system. But it is 
not known that oxygen performs any other office than to com- 
bine with and reduce to ashes, and thus favor the expulsion of 
the disintegrated or dead matters. Oxygen is usually termed 
"vital air," but I suppose the vitalizing element is something 
.very different. 

So far as we can trace the effects of oxygen, they are purely 
destructive. Of course it is just as important to get rid of the 
offal, to remove the effete matters from the system, as it is to 
supply wholesome food. And for this purpose a full supply 
of oxygen is a vital condition. But this does not make it in any 
sense ' * vital air, " any more than nitrogen is vital air, for a due 
admixture of this gas. with the oxygen is just as essential to 
health as is the presence of the oxygen. 

Pure oxygen is as non-respirable as is nitrogen, carbonic 
acid gas, or hydrogen ; although a larger proportion of it in the 
atmosphere than nature provides may be borne for a time with- 
out serious inconvenience. Those empyrics, however, who 
run the business of treating diseases with * * Compound Oxygen, (i 
"Super-Oxygenated Air," "Vitogen," and other humbugs, 
must either be arrant ignoramuses, or have great faith in human 
credulity. These enterprising gentlemen might as well under- 
take to invent better kinds of food, or a superior quality of 



AERATION OF THE FOOD ELEMENTS. 6 1 

water than nature has been enabled to accomplish, by chang- 
ing the proportions of their constituent elements, as to imagine 
they can improve the atmosphere nature has provided for us 
to breathe. 

In my opinion the vitalizing principle which may pervade 
any organic structure, and which is especially received in respi- 
ration, is an element inconceivably more refined than oxygen 
or its nascent condition, ozone, and more etherealized than 
even the all-pervading electricity or magnetism, and which fills 
all that part of the unmeasurable universe which is called space. 
But, for all practical purposes it is enough to know that perfect 
respiration is essential to perfect nutrition, and that every influ- 
ence which diminishes the breathing capacity, correspondingly 
impairs digestion and conduces to dyspepsia. 

All impurities of the atmosphere tend to enfeeble the respira- 
tory, and indirectly, the nutritive functions, as do all habits of 
dress or positions of body which impede the action of the respi- 
ration. And here I must allude to two prevalent causes of dys- 
pepsia, consumption, and general physical deterioration, which 
are not only destroying the young men and young women of 
our land at a fearful rate, but are alarmingly on the increase 
all over the country. 

I cannot do better justice to this branch of our subject 
than by quoting a few paragraphs from one of my works on 
1 Tobacco-Using," recently published at the office of the Health 
Reformer, at Battle Creek, Michigan : 

"the breath of life. 

"There is one view of the physical evils of tobacco-using 
which has never been presented distinctly by writers on this 
subject. I mean the effect of the habit of respiration. Tobacco- 
using directly and fearfully lessens the breathing capacity. This is 
one reason why tobacco-users require more sleep than others, 
other circumstances being equal.* Now, the available life- 

* The less the nervous energies are exhausted by nervines, stimulants, or narcotics of 
any kind, or, indeed, by pernicious habits of any sort, the less will be the amount of sleep 
required for recuperation. 



62 DIGESTION. 



force of every living being is precisely in the ratio of the devel- 
opment of the respiratory organs. Tobacco-using, so long as 
it is continued, constantly diminishes the breathing apparatus. 
This is easily explained. Any one, on going, on a hot sum- 
mer's day, from the stifling stenches of an uncleaned city, to the 
purer breezes of the open country, may have a realizing sense 
of the principle involved. His lungs will expand spontane- 
ously. They seem to open full and deep to take in as much 
vital air as possible. It is a luxury to breathe. But in the 
dirty city, the accumulated impurities of the atmosphere are 
resisted by the pulmonary structures. The glottis partially 
closes to keep them out, and all of the respiratory muscles 
contract spasmodically ■ to prevent their entrance. Breathing 
is, therefore, imperfect. And when the atmosphere is very 
impure, breathing is not only imperfect but painful ; and in 
extreme cases it is entirely suspended. 

1 ' Now, nothing is more offensive to the vital instincts of the 
respiratory organs than the odor and fumes of tobacco. Talk 
about stenches, miasms, contagions, infections, from gutters, 
cess-pools, markets, stables, distilleries, tenement houses, offal 
gatherings, &c. ! All of them combined (let me gently hint to 
the Board of Health) do not equal tobacco in intrinsic repul- 
siveness, nor in their injurious effects on the lungs. 

1 ' Let any one, uncontaminated by its use, enter a close room 
where several persons are smoking, or a crowd in the street 
where fashionable young men most do congregate, and, in a 
moment, he will find himself breathing short and laboriously. 
He will experience a sense of suffocation, and perhaps feel an 
inclination to sneeze, retch, or vomit. His lungs expand with 
difficulty. They ' do not kindly receive the particles of the 
deadly narcotic. Inhalation is feeble and imperfect, while ex- 
piration is more forcible and complete. And thus the lungs 
are exercised in just the manner gradually and surely to contract 
the diameter of the chest and permanently diminish the respi- 
ratory capacity. And as our whole population is more or less 
exposed to an atmosphere strongly impregnated with tobacco 
effluvia, the vital function of respiration cannot fail to suffer a 



AERATION OF THE FOOD ELEMENTS. 63 

continual deterioration. And all that is necessary to insure the 
ruin of the human race at no distant day is the increase of the 
habit of tobacco-using as rapidly as it has increased for three 
centuries past, or as rapidly as it is increasing at the present 
time. Frightful examples of this possible result may be seen 
in droves in all of our cities and large villages. 

"Look at the swarms of young men — young in years, but old 
in vital conditions — who commenced this horrid practice in 
early life ; and thousands do commence it even before the age 
of puberty. The close observer will not fail to notice in a ma- 
jority of them, something unshapely and unhuman — the sharp 
features, angular faces, projecting shoulders, lank limbs, nar- 
row chests, gaunt abdomens, sallow, bilious skin, and old-man- 
ish appearance generally. To the eye of the intelligent phy- 
siologist these young men — mere boys in the order of nature — 
are prematurely old, already in a decline. I have seen thou- 
sands of tobacco-using young men (of twenty to twenty-five 
years of age, according to the almanac) who were physiologi- 
cally and for all practical purposes, older than thousands of 
their fathers and grandfathers were at fifty to sixty years of age. 
A large proportion of tobacco-using young men are dwarfed in 
body and mind irrecoverably ; and should they unfortunately 
become husbands and fathers, their wives may well be pitied, 
while their offspring will m most cases be constitutionally frail 
and precociously dissolute, and many of them imbecile, if not 
idiotic. 

* ' Many of these young men have the characteristics of disso- 
luteness and sensuality stamped indelibly on the physiognomy 
as well as the physiology. And with many of them — indeed 
all, to a greater or less extent — their secretions are all morbid, 
their excretions defective ; their whole mass of blood foul, their 
breath fetid, their sweat nauseous, and their whole persons 
offensive. * 

"young men the chief smokers. 

"As we trace the history of tobacco-using from one genera- 
tion to another, it is all downward — from bad to worse. The 



64 DIGESTION. 



fathers of many of the tobacco-using young men of the present 
day did not commence the habit until they had acquired a fair 
vital development. But they transmitted morbid propensities 
to their children, who commenced much earlier in life. Hence 
there is frequently a striking contrast between the compara- 
tively stalwart tobacco-using father, and the puny, fragile, 
stunted, and inferior tobacco-using son. It is not difficult to 
imagine what their sons must be. 

" It is worthy of remark that, as a general rule, persons who 
become addicted to tobacco-using (and the same is true of 
liquor-drinking) in early life, indulge more excessively than 
do those who commence in middle or mature life. Being 
excitable, the consequent depression is greater ; hence the 
seeming necessity for more frequent repetitions. 

" A few days since, I noticed an illustration of this statement, 
which will, I think, be found of extensive application. I was 
travelling from Philadelphia to New York. The car in which I 
was seated contained just forty persons. Eight of them were 
young men ; twenty-two would pass for middle-aged, and ten 
were old persons — six men and four women. All of the young 
men (and this was not the " smoking car, forward") smoked 
cigars or huge meerschaums more than half of the whole dis- 
tance ; only two of the middle-aged men smoked at all, and 
then cigars only on one occasion for a few minutes ; while but 
one of the old gentlemen befouled himself and the rest of us by 
smoking at all. I have made similar observations on all the 
leading railroads of the United States, and I am of the opinion 
that if any person, travelling in any part of the country by rail, 
steamer, ferry, or stage, will study this subject closely, he will 
find that the principal smoking is done by the young men. 
Tens of thousands of young men may be seen every Sunday 
standing around the corner groceries, and the thousands of 
tobacco shops (which find Sunday their principal business day 
of the week), smoking their lives away, and bestenching the 
atmosphere which others are obliged to breathe. And in every 
public gathering outside of a church, it may be readily noticed 



TOBACCO-USING. 65 



that the principal smoking is performed by the young men and 
boys. 

"Tobacco-using, in young persons, has the same effect in 
diminishing the breathing capacity that tight-lacing (which is 
alarmingly on the increase again) has. Some years ago, when 
the practice of tight-lacing, which has ruined many thousands 
of young ladies, induced the friends of humanity and of the 
future generations, to make special efforts to arrest the evil, 
many young men adopted the maxim, ' natural waists or no 
wives. ' It is a pity the maxim was not more generally lived up 
to. But these young ladies might very well reciprocate the 
compliment while they accepted the philosophy in adopting the 
adage, ' natural mouths or no husbands. ' Examples are, in- 
deed, sadly frequent on the thoroughfares of our great cities, of 
young ladies who have destroyed more than one-half of their 
breathing capacity by this disgraceful habit of tight-lacing. 
They cannot possibly live to be old ; they can never become 
mothers of healthy children ; and while they do live they must 
be infirm and miserable in themselves, and a source of anxiety 
and sorrow to their friends. They are invalids for life. Their 
wan, expressionless faces, harsh, pinched, contracted features, 
with livid, bilious discolorations of the skin, proclaim in lan- 
guage that the physiologist cannot mistake, deficient respiration 
and imperfect depuration. And the counterpart of these 
appearances and indications may be seen in numerous young 
men who promenade the streets behind lighted cigars. 

"But although the physiological result is the same in the 
cases of tobacco-using young men and tight-lacing young 
women, there is a considerable difference anatomically. In 
the case of the young ladies the obstruction to respiration is 
external and mechanical, hence there is greater deformity, or 
* caving in/ of the vital organs, while, with the young men, 
there is less malformation or deformity of the chest. 

"Let a tobacco-using young man and a tight-lacing young 
woman marry, and what must be the character of the off- 
spring ? We can see melancholy specimens enough on every 
hand. 



66 DIGESTION. 



' ' Now the only method which has ever proved effectual for 
preventing or curing consumption is, to keep the lungs ex- 
panded as much as possible. And for this purpose, breathing 
tubes, spirometers, blow-guns, lifting machines, and other 
gymnastic contrivances, have been found useful. 

A LEARNED DISCUSSION ON TOBACCO. 

"I cannot better illustrate the delusion that may exist in 
high places, even among the learned, on the subject of tobacco- 
using, than by the relation of the following incident : In 1862, 
I attended the annual meeting of the British Scientific Associa- 
tion, in Cambridge, England. In the section on Physiology, 
a paper was read on the evil effects of tobacco-using. The 
author stated very clearly the various morbid conditions and 
diseases which are well known to result from the habit, and 
quoted a respectable array of medical authorities who declared 
it to be extremely pernicious. The discussion that followed 
the reading of the paper was amusing, if not instructive. Every 
one who spoke on the subject (and they were all medical gen- 
tlemen), condemned, not the tobacco, but the author of the 
essay! 'He was not a competent judge.' 'His opinions 
w r ere of no authority.' 'He was no physiologist,' etc. All 
who spoke, advocated the use of tobacco — moderately, of 
course. One gentleman said that, ' next to alcohol, tobacco 
was the best-abused article in existence.' Another stated that 
he had used the ' weed ' for twenty-three years without being 
harmed by it. A third regarded it 'favorable to mentality,' a 
fourth considered its employment in moderation ' decidedly 
hygienic. ' A fifth said, ' I always find my ideas to flow more 
consecutively after a few whiffs from a good cigar ;' and a sixth 
■ustified its use by reference to the Turks, ' who used tobacco 
freely, yet were a strong and courageous race. ' No one replied 
a word to the facts, or pretended to meet the arguments pre- 
sented in the paper ; but all who spoke, contented themselves 
with the utterances of opinions in praise of tobacco, and de- 
nunciations of the author. Surely, if an association of scienti- 
fic men whose members claim to be as learned a body as exists 



TIGHT-LACING. 67 



on the earth, can gravely utter such arrant fallacies, we need 
not wonder at the wide-spread ignorance of the non-professional 
people on this subject. 

The importance of the subject of tight-lacing, and abnormal 
positions when habitually assumed, as affecting respiration and 
digestion, cannot, perhaps, be better stated and illustrated than 
in the following chapter on "Popular Physiology," a serial 
work now being published in the ' - Science of Health. " The 
illustrations are from a work by the author, entitled, "The 
Illustrated Family Gymnasium. " 

BODILY POSITIONS. 

"A single glance at the situation of the various organs of 
the body, with respect to each other and to the bony skeleton, 
shows the importance of maintaining, under all circumstances, 
the normal position. Erectitude is one of the most obvious 
laws of the vital machinery, yet almost every one is crooked. 
* Blessed are the upright/ physically as well as morally. 

' ' Each structure and organ is provided with all the room 
necessary for its functional purposes, but no more. Nature is 
a rigid economist. She never wastes. She provides the ma- 
chinery of life, and the conditions for its normal operation. 
Obey the law and live, disobey and die — these are her irrepeal- 
able mandates. The vital organs have definite relations to 
everything in the universe. Observe and conform to these 
relations and be well ; disregard them and suffer. Such is the 
stern teaching of Nature's volume. But it is also benevolent. 
If laws can be disregarded with impunity, they are practically 
annulled, and exist in vain. Nature commits no error in the 
enactment of law, and provides no remedies for their infraction. 
Suffering is inevitable so long as we act in disobedience to the 
laws inherent in the vital organism. Unless this were so we 
could never learn to obey the laws. Experience may be a dear 
school. The penalties for transgression may be terrible. But 
neither is too costly or severe until it teaches us the greatest 
practical truth that the human mind is capable of comprehend- 



! 



68 DIGESTION. 



ing — that all good is in the line of obedience to organic law, 
and all evil in opposition thereto. 

" ' Cease to do evil and learn to do well ' in all things, is the 
divine philosophy, and applicable to every department of 
human life. In few things are human beings more prone to 
do evil and more regardless of all health considerations than in 
respect to bodily positions. 

•Just as the twig is bent the tree's inclined. * 

" A great majority of children in our primary schools become 
more or less abnormally inclined in manhood, because they are 
bent out of shape in childhood by unhygienic seats and 
benches. 

"In the cut (^Fig. 35; are seen the situation and relations 
of the principal internal organs of the body. 

"The important lesson deducible from the illustration before 
us is, that in all of our exercises, active or passive, we should 
maintain the normal positions of the organs. In lying, sitting, 
standing, walking, running, working or playing, use the joints, 
and never bend or compress any other organ, part or struc- 
ture. 

"It is evident that, if the body is habitually bent so as to 
approximate the heart, A, and stomach, D, or if the chest is 
restricted by lacing, so as to lessen the diameter of the chest in 
the region of the diaphragm, d, every organ of the thoracic and 
abdominal cavity is more or less compressed, and most of 
them actually displaced. 

"The horrid effects of tight-lacing (quite as ruinous to young 
ladies as tobacco-using is to young men), or of lacing at all, 
and of binding the clothing around the hips, instead of sus- 
pending it from the shoulders, can never be fully realized with- 
out a thorough education in anatomy and physiology. And if 
the illustrations here presented should effect the needed reform 
in fashionable dress, the resulting health and happiness to the 
human race would be incalculable ; for the health of the 
mothers of each generation determines, in a very large mea- 
sure, the vital stamina of the next. 



TIGHT-LACING. 



69 



"It is obvious that, if the diameter of the chest, at its lower 
and broader part, is diminished by lacing, or any other cause, 
to the extent of one-fourth or one-half, the lungs, B, B, are 
pressed in towards the 



in 

heart, A, the lower ribs 
are drawn together and 
press on the liver, C, and 
spleen, E, while the ab- 
dominal organs are press- 
ed downward, D, on the 
pelvic viscera. The 

stomach, B, is compress- 
ed in its transverse diam- 
eter; both the stomach, 
upper intestines and liver 
are pressed downward on 
the kidneys, M, M, and 
on the lower portions of 
the bowels (the intestinal 
tube is denoted by the 
letters,/"/, and k), while 
the bowels are crowded 
down on the uterus, i, 
and bladder, g. Thus 
every vital organ is either 
functionally obstructed or 
mechanically disordered, 
and disease, more or less 
aggravated, the condition 
of all. In post-mortem 
examinations the liver has 




Fig. 35. — Internal Viscera. 



been found deeply indented by the constant and prolonged 
pressure of the ribs, in consequence of tight-lacing. 

' ' The brain-organ, protected by a bony inclosure, has not yet 
been distorted externally by the contrivances of milliners and 
mantua-makers ; but, lacing the chest, by interrupting the cir- 
culation of the blood, prevents its free return from the vessels 



7o 



DIGESTION. 



of the brain, and so permanent congestion of that organ, with 
constant liability to headache, vertigo or worse affections, be- 
comes a " second nature." And this condition is often aggra- 
vated by heavy water-falls, chignons and other ridiculous head- 
gear. 

" The vital resources of every 
person, and all available pow-* 
ers of mind and body, are 
measurable by the respiration. 
Precisely as the breathing is 
lessened, the length of life is 
shortened ; not only this, but 
life is rendered correspondingly 
useless and miserable while it 
does exist. 

'It is impossible for any 
i child, whose mother has dimin- 
ished her breathing capacity by 
lacing, to have a sound and 
vigorous organization. If girls 
will persist in ruining their 
vital organs as they grow up to 
womanhood, and if women 
will continue this destructive 
habit, the race must inevitahl) 
deteriorate. It may be assert- 
ed, therefore, without exaggera- 
tion, that not only the welfare 
of the future generations, but 
the salvation of the race de- 
pends on the correction of this evil habit. 

" The pathological consequences of continued and prolonged 
pressure on any vital structure are innutrition, congestion, 
inflammation and ulceration, resulting in weakness, waste of 
substance and destruction of tissue. The normal sensibility 
of the part is also destroyed No woman can ever forget the 
pain she endured when she first applied the corsets ; but in 




Fig 36 — Anterior View of the Tho- 
rax in the Venus of Medicis. 



TIGHT-LACING. 



71 



time the compressed organs become torpid ; the muscles lose 
their contractile power, and she feels dependent on the me- 
chanical support of the corset. But the mischief is not limited 
to local weakness and insensibility. TKe general strength and 
general sensibility correspond with the breathing capacity. If 
she has diminished her * ' breath of life, " she has just to that 
extent destroyed all normal sensibility. She can neither feel 
nor think normally. But 
in place of pleasurable 
sensations and ennobling 
thoughts, are an indescriba- 
ble array of aches, pains, 
weaknesses, irritations, and 
nameless distresses of body, 
with dreamy vagaries, fitful 
impulses and morbid senti- 
mentalities of mind. 

' ' And yet another evil is 1 
to be mentioned to render 
the catalogue complete. 
Every particle of food must 
be aerated in the lungs be- 
fore it can be assimilated. 
It follows, therefore, that no 
one can be well nourished 
who has not a full, free 
and unimpeded action of the 
lungs. 

' ' The effects of improper 
dress on the bony skeleton, 

and especially on the Spinal FlG: 37 -The Same in a Lady Deformed 
■'-,■.*"•« by Stays. 

column, are shown in Figs. 

36, 37, 38, and 39, which every physician knows are not over- 
drawn. 

"In the contracted chest, represented by Fig. 37, (by no 
means an uncommon case), the external measurement is re- 
duced one half; but as the upper portions of the lungs cannot 




72 



DIGESTION. 



be fully inflated until the lower portions are fully expanded, it 
follows that the breathing capacity is diminished more than 
one-half. It is wonderful how any one can endure existence 

or long survive, in this de- 
vitalized condition ; yet thou- 
sands do, and, with careful 
nursing, manage to bring 
into the world several sickly 
children. 

"The spinal distortion 
( Fig. 39) is one of the ordi- 
nary consequences of lacing. 
No one who laces habitually 
can have a straight or strong 
back. The muscles being 
unbalanced, become flabby 
or contracted, unable to 
support the trunk of the 
body erect, and a curvature 
— usually a double curva- 
ture — of the spine is the 
consequence. 

"And if anything were 
needed to aggravate the spi- 
nal curvature, intensify the 
compression of the internal 




Fig 



37.— Posterior View of the Thorax 
in a> -natural state 

viscera, and add to the general deformity, it is found in the 
modern contrivance of stilted gaiters These are made with 
heels so high and narrow that locomotion is awkward and pain- 
ful, the centre of gravity is shifted 'to parts unknown/ and the 
head is thrown forwards and the hips projected backwards to 
maintain perpendicularity, rendering walking and all other 
voluntary exercises not only distressing to the person, but dis- 
agreeable to the spectator. 

* ' To sit or stand in a crooked position, inclining the head and 
knees forwards, overstretches the middle spinal muscles, re- 
verses the normal curvature of the spinal column, compresses 



TIGHT-LACING. 



73 



the liver, stomach and lungs, and is in effect equivalent to lac- 
ing the waist. Figs. 40 and 41 show the right and wrong 
positions in standing. 

''Sleeping on two or three 
pillows, or on a bolster and 
pillow, is a prevalent yet per- 
nicious custom. If long con- 
tinued the effect is surely a 
distortion of the spine to some 
extent. If the head is raised 
high while sleeping, the stom- 
ach and lungs are injuriously 
compressed, and the upper in- 
testines pressed downward on 
the pelvic organs. If children 1 
are allowed to sleep habitually | 
on high pillows, spinal curva- 
ture and general debility will 
be the inevitable conse- 
quences. One pillow is 
enough for any person, and 
that should be only of mode- 
rate size. Figs. 42 and 43 
exhibit the right and wrong 
positions in contrast. 

1 'Malpositions in sitting seem 
to be among the increasing 
evils of high civilization without physiological education. This 
habit is mainly attributable to the immensely unanatomical 
construction of chairs, benches, sofas, pews, etc. Not one 
school-house in all the land, not excepting those in which 
physiology is professedly taught, has a chair or a bench that a 
child can sit upright on without a constant and consciously 
painful effort. Nor have we ever seen, in private families or 
public institutions, halls or churches, stages or ferry-boats, rail- 
road cars or steamers, a single seat constructed on hygienic 




Fig. 39. — Distorted Spink. 



74 



DIGESTION. 



principles, 
positions. 



Figs. 44 and 45 show the normal and abnormal 





Fig. 40 — Standing Erect. Fig. 41. — Malposition. 

Children who early acquire and continue in the habit of sit- 
ting in normal or abnormal positions will either preserve the 
erectitude of the spinal column as shown in Fig. 46, or become 
crooked-backed, as seen in Fig. 47. 

It is apparent that, inclining the head forwards and bending 
the body at the middle of the back, instead of on the hip-joints, 
necessitates a backward projection of the entire spinal column, 
with a corresponding incurvation or pressure anteriority ; hence 
the whole body is distorted from the crown of the head to 
the soles of the feet ; more than a hundred muscles are un- 
balanced, and every organ and limb is weakened. 

In all exercises, in walking, running, lifting, and in manual 
labor, the power of the individual is always determined by the 



POSITION. 



75 



number of muscles that are brought into co-operative action. 
But if the body be crooked, or any part of it out of the normal 
relation to other parts, 
some muscles will be 
strained by over ac- 
tion, while others will 
become relaxed from 
insufficient action, 
and all weakened — 
just as in the crooked 
ways of society some 
persons are drudged 
to death while others 
die of indolence. 




Fig. 42.— Proper Position in Bed. 




If seats were pro- 
perly constructed per- 
sons would sit up- 
right, for the reason 

that it would be the Fig. 43 —Improper Position in Bed. 

most comfortable position. It would be painful to sit other- 
wise. The chairs, benches, sofas, pews or other seats, should 





Fig. 44. — Correct Sitting Position. 



Fig. 45.— Misposition in Sitting. 



76 DIGESTION. 



fit the small of the back, the curve of the hips and the whole 
length of the thighs, as accurately as a well-made shoe is shaped 
to the foot, or harness to the body of a horse. But the com- 




46. — Natural Spinel 47. — Distorted Spine. 

mercial articles reverse this rule ; they press unduly on the 
upper part of the thighs and the upper part of the back, and 
afford no support whatever where it is principally needed. 
Moreover, in addition to the defective shape, they are, on the 
average, two inches too high, rendering it impossible for the 
feet to rest evenly and easily on the floor. No wonder that, on 
chairs which are a torment to one who tries to sit erect, per- 
sons are continually leaning back against the wall, drawing 
up their feet, placing one foot across the opposite knee, brac- 
ing one or both feet against the chair rounds or any adjacent 
object, and getting into all sorts of uncouth and ridiculous 
attitudes. 

The cut (Fig 48) represents the outline of our ideal chair. 



POSITION. 



77 



We place it on record for the benefit of the future generations, in 
the hope that some ingenious mechanic or pecunious philan- 
thropist will supply one of the great wants L 
of the age by introducing it" u 

As normal sensibility is intimately con- 
nected with respiration, the depression and 
melancholy so common to dyspeptics whose 
chests are contracted, are readily accounted 
for. Many of these invalids have, by tight- 



rn>- 



fi 

! i 



Fig. 48. 
The Anatomical Chair* 



lacing or other unhygienic habits, so 
changed the form of the chest as to render 
it concave in front where it should be 
round and full, thus preventing the descent 
of the diaphragm in inhalation and ren- 
dering a full inflation of the lungs impos- 
sible. 

In the illustration (Fig. 49), 
which is a side view of the chest 
and abdomen in respiration, the 
importance of the unimpeded mo- 
tion of this muscular structure 
which divides the cavities of the 
thorax and abdomen may be re- 
cognized at a glance. 

1. Cavity of the Chest 2 Cavity of the Ab- 
domen. 3. Line oi direction for the diaphragm 
when relaxed in expiration. 4. Line of direc- 
tion when contracted in inspiration. 5, 6 Posi- 
tion of the front walls of the Chest and Abdomen 
in Inspiration 7, 8 Their position in expiration 

The careful reader will now have 
no difficulty in understanding why 
it is that the women of our country 
are so much more dyspeptic, as a 
general rule, than the men, and so Fig. 49. Action of the Diaphragm. 
much more predisposed to consumption. 

Let us complete the illustration by contrasting the forms of 
features of one who has, by tight-lacing, acquired the abnormal 




7 8 



DIGESTION. 




shape of the chest, with its necessary accompaniment of a wan, 
dejected, and expressionless face, (Fig. 50,) and a " human 
form divine/' whose breathing capacity 
and life-resources are shown in a full 
expanded respiratory apparatus, and a 
correspondingly vitalized, hopeful, and 
intelligent countenance — such as 
sculptors and painters delight to fash- 
I ion and exhibit in marble and on can- 
vas, and such as admiring crowds will 
gaze upon for hours with pleasure. 

Those persons who are distinguished 
as having a "fine flow of animal spi- 
rits, " invariably have a free play of the 
Fig. 50— Unnatural Waist, respiratory system. The blood being 
w r ell purified and the food elements properly aerated, the circu- 
lation is well maintained on the surface, and the patient is not 
disturbed by nor sensitive to slight changes of temperature, nor 
chilled with an easterly wind or the fog of a morning, as is 
the case with those who do not breathe sufficiently. And 
these half-breathing mortals are always feeling the need of 
some artificial support, and are hence more liable to resort to 
various stimulating viands and pungent condiments, which only 
mitigate their sufferings temporarily, to be followed by collapse 
and augmenting debility. 

The editor of a monthly periodical, ("Hall's Journal of 
Health,") some years ago advanced a theory on the relation ot 
respiration to consumption as novel as it was absurd. And as 
the author has written a book on consumption, and sells medi- 
cines for consumption through the press, and, moreover, as his 
journal has attained a large circulation, and is often quoted as 
good authority by country newspapers, his ingenious views are 
worthy of a passing refutation. 

Briefly stated, the new and original theory amounts to just 
this : 1. Consumption is tuberbulosis of the lungs. 2. Tu- 
berculation of the lungs usually commences in the upper por- 
tion. 3. A due expansion of the lungs prevents the formation 



position. 79 



of tubercles. Ergo, By constricting the lower portion of the 
lungs, as by tight-lacing, the upper portions of the lungs are 
forced to do the breathing which the lower portions are pre- 
vented from doing, and hence tight-lacing and such other 
machinery or habits as diminish respiration in the lower part 
of the lungs are remedial. They are both preventive and 
curative of consumption. 

Ridiculous as this reasoning may seem to any tyro in physi- 
ology, it has appeared so plausible to some invalids that they 
have been misled by it. But a little deeper insight into the 
anatomy and physiology concerned will at once dissipate the 
delusion. The competent physiologist well understands that, 
in the act of respiration, the lower portions of the lungs are 
always expanded before the upper portions can be filled with 
atmospheric air ; hence whatever tends to restrict inhalation in 
their lower portions must inevitably diminish still more the 
respiratory capacity of the upper portions, and favor tubercula- 
tum. If the 10,387 deaths which occurred in New York in 
1872, of the four diseases most immediately connected with 
respiration, viz., consumption, scrofula, pneumonia, and 
bronchitis, a large proportion of whom were young women, do 
not point the proper moral on this subject, then there is no use 
in mortuary statistics. 

The greater prevalence of dyspeptic and consumptive diseases 
among women than men has caused some medical writers to 
theorize that the explanation is to be found in original frailty. 
But the contrary is true. In the normal condition woman has 
the stronger vital and nutritive temperament, and is, constitu- 
tionally, less predisposed to either consumption or dyspepsia 
than man. There is a necessity and a reason for this. She is 
provided by nature with a nutritive apparatus not only compe- 
tent to nourish and sustain her own structures, but also able 
to develop and nourish offspring. My opinion is, that, if men 
would dress as the majority of women in fashionable life do, 
there would be ten cases of consumption among them where 
there is one now. 

Another very prevalent source of dyspeptic conditions in 



8o DIGESTION. 



youth, resulting very frequently in consumption soon after ma- 
turity, if not before, deserves special mention in this place, for 
the special reason that it is never mentioned in medical books, 
and seldom thought of by parents and teachers. I mean our 
common schools. We are accustomed to impute our progress, 
morality, and intelligence, to our churches and schools. This 
is true, with some grains of allowance. But these drawbacks 
are very serious ones. Most of the school-houses in our cities, 
and not a few in the country, are pest-houses, very much in 
the sense that tenement houses are. They are not properly 
warmed in winter, and not properly ventilated at any season. 
They are' too hot or too cold in winter, and too redolent of 
miasm in the summer. The scholars cannot get fresh air in 
cold weather without a chilling draft, nor pure air in warm 
weather under any circumstances. Many a private mansion, 
occupied by half-a-dozen persons, has more of the "breath of 
life " circulating through its rooms, than have some of our ward 
school-houses where several hundred children are tortured into 
"book knowledge, at the expense of vitality. As the air in 
the room where fifty or a hundred children are crowded toge- 
ther, is constantly vitiated by the exhalations from the skin and 
lungs, it is impossible, in cold weather, to ventilate sufficiently 
from the doors and windows without rendering the atmosphere 
in various parts of the room too variable and uneven for health. 
The only proper method of warming school-houses — and the 
plan is equally applicable to churches, public halls, theatres, 
etc. — is to have the fresh air conveyed from the outside of the 
building, or from the hall within, through a tube or pipe under 
the floor, to be discharged under the stove, or better still, into 
the cylinder or air box adjoining the stove, so that the air could 
be warmed before being diffused through the room. This 
arrangement would secure a uniform temperature, and purify 
the air without occasioning unwholesome or even unpleasant 
currents. When buildings are heated by steam the same 
arrangement for supplying fresh air is equally desirable, the 
outer air being admitted under or adjoining the radiating coil 
or plates. 



POSITION. 8 1 



Moreover, school-children are, as a rule (I know of no ex- 
ceptions), made to "sit still" too many hours in the day, and 
on unhygienic seats at that. Not one growing child in ten can 
be confined in a school more than three hours a day without 
suffering more or less of debility and endangering life. Our sys- 
tem of forced education — developing brain, or trying to, before 
there is a physical basis — is all wrong, and is filling the land 
with educated imbeciles — I mean young persons who have 
information and accomplishments, but are useless to themselves 
and a burden to others, because of ill-health. I regard school- 
houses as among the worst causes of the general frailty, dys- 
peptic tendencies, and consumptive sequaela that are said to be 
peculiarly Av /sric in. 




Arbor Morboritm. 



DYSPEPSIA. 



PART II. 

IDYSPEPSIA. 



CHAPTER X. 
NATURE OF DYSPEPSIA. 

As digestion is the most complex of all the organic processes, 
its derangements, which constitute indigestion, or dyspepsia, 
are the most complicated of all morbid conditions. Patho- 
logically it may be said to be the sum of all chronic diseases, 
as fever may be said to be the aggregate of all acute diseases ; 
for there is not a symptom in all of the one thousand diseases 
which make up the nosology, that is not found in some form, 
state, or stage, of both dyspepsia and fever, with the single 
exception of those which appertain to structural lesions. If all 
the ' * phenomenology " which the confirmed dyspeptic experi- 
ences in six or twelve months were suffered in the period of 
twelve or twenty-four hours, the disease would be termed fever, 
instead of dyspepsia ; and if the symptoms which belong to a 
paroxysm of fever, and which mark its cold, hot, and sweating 
stages, were extended over a period of some weeks or months, 
the disease would be termed dyspepsia instead of fever. In 
both cases the inability to nourish the body sufficiently is a 
leading feature of the morbid manifestations ; but in fevers, 
properly so called, the power of digestion and assimilation is 
wholly suspended in the early stage, while in dyspepsia it is 
only impaired. 

It is a great mistake to regard dyspepsia as peculiarly or 
especially a disease of the stomach. We have seen, in the 
preceding explanations and illustrations, how essentially co- 



NATURE OF DYSPEPSIA. 83 

operative are a multitude of organs and structures in the digestive 
processes. And they are. just as co-implicated in the derange- 
ment of these processes. In some cases one structure or organ 
will be more obstructed, impaired, or deranged than others, and 
in other cases two or more will be the seat of the more trouble- 
some symptoms. Thus, one dyspeptic may have one of several 
morbid conditions of the liver, as torpidity, congestion, indu- 
ration, chronic inflammation, gall-stones, or abscess, as the 
special complication of his case, and attended with jaundice, 
difficult breathing, or palpitation, a sense of weight, tenderness 
in the right side, spasms near ihe pyloric orifice, or throbbing 
pains, as the most prominent symptom. Another will have 
great distress, "goneness," acrid eructations, sick headache, 
a cramp in the stomach, because of the acid and putrescent bile 
which is occasionally emptied into the duodenum just below 
the pit of the stomach. A third may have constipated bowels, 
and a fourth diarrhoea, and a fifth these states interchangeably, 
as the most troublesome manifestation of the general ailment ; 
a' sixth may have the vessels of the head so clogged with viscid 
blood as to experience more headache, either constant or 
periodical, than anything else to complain of; a seventh may 
feel great distress after eating ; an eighth, frequent paroxysms of 
\iiausea and vomiting ; a ninth, capricious or craving appetite ; a 
tenth loss of all appetite ; an eleventh, canker in the mouth, or 
stomatitis; and a twelfth, general prostration, hypochondria, or 
nervous debility, as the more distressing part of his case. Many 
dyspeptics suffer in ail of these ways, and have the symptoms 
above enumerated as changeable as the winds, and quite as 
uncertain with regard to rules for calculation as the weather 
" probabilities." 

Medical authors generally assign ' f weakness of the stomach " 
as the essential proximate cause of dyspepsia. They might as 
well say, weakness of the head, or heart, or hands, or feet ; all 
are weak when the digestive processes fail to supply the ele- 
ments of strength ; and the debility of the stomach or other 
digestive organs, in any case of dyspepsia, is no greater and no 
worse than that of all other parts of the body. Indeed, the 



84 DYSPEPSIA. 



difference is just the other way, for nutrition, being the first 
and last process of organic life, all other parts of the system are 
disproportionately debilitated when the digestive function is 
impaired. Dyspepsia is, therefore, but a name for universal 
physical deterioration, although the symptoms of the general 
condition may embrace all the aches, pains and distresses that 
our language can express. 

The error of regarding dyspepsia as a local disease instead of 
a constitutional infirmity, leads to the mischievous practice of 
local medication ; and the weak stomach is excited with stimu- 
lants, urged with tonics, soothed with nervines, quieted with 
opiates, and modified with alteratives, while the other "chy- 
loipcetic viscera/' especially the ever-involved liver, are treated 
to mercurials, not forgetting to remind the bowels of their re- 
missness of duty by a succession of purgatives. These are 
excellent methods for curing dyspepsia by killing the patient, 
or to mitigate symptoms by destroying vitality. 

Professor George B. Wood, M. D., of Jefferson Medical 
College, Philadelphia, is the author of the latest and largest 
American work on the Theory and Practice of Medicine. In 
this work (" Wood's Practice of Medicine"), which is a text- 
book in our medical colleges, the author informs us that, 
"The most prolific source of dyspepsia is probably the com- 
bined influence of sedentary habits and errors of diet." 

This being the case, it would surely seem that the combined 
influence of appropriate exercise and a correct dietary ought to 
be the sufficient remedies. The Professor does indeed tell 
many things useful in the list of eatables and drinkables, and 
some articles of each class to avoid, but the strange part of the 
story is that he recommends, on his own reputation, or com- 
mends on the opinion of other authors, in the treatment of 
dyspepsia and its incidental affections, no less than a dozen 
classes of medicines, and more than one hundred individual 
drugs, to say nothing of the unmentioned ingredients in the 
compounds, and the bleeding and blistering processes. 

The individual remedies are, ipecacuanha, rhubarb, aloes, 
castile soap, croton oil, Cheltenham salts, Saratoga water, 



NATURE OF DYSPEPSIA. 85 

(which contains no less than ten drugs) sulphur, mustard seeds, 
magnesia, quassia, columbo, gentian, chamomile, wild cherry 
bark, serpen taria, carbonate of iron, copperas, carbonate of 
soda, carbonate of potassa, powder of iron, tincture of chloride 
of iron, iodide of iron, chalybeate mineral waters, oil of vitriol, 
aqua fortis, muriatic acid, nitro-muriatic acid, subnitrate of 
bismuth, white vitriol, lunar caustic, lactic acid, pepsin, rennet, 
carbonic acid water, creosote, senna, orange peel, cloves, car- 
damom, fennel seed, mercurial or blue pill, calomel, salt (in 
the form of a warm salt bath), opium, mustard plaster, cayenne 
pepper (in the stockings), burgundy pitch (as a plaster), ex- 
tract of dandelion, magnesia, bicarbonate of soda, lime water, 
prepared chalk, prepared oyster shell, carbonate of ammonia, 
aqueous solution of ammonia, aromatic spirit of ammonia, 
powdered charcoal, compound cathartic pill (composed of 
several drugs), seidlitz powder, castor oil, mustard sinapisms 
(over the stomach), preparations of codeia, leeching, cupping, 
blisters, tartar emetic, setons, issues, moxa burnings, henbane, 
stramonium, deadly night shade, extract of hemp, lactucari- 
um, chloroform, prussic acid, tobacco (smoking), acetate of 
morphia, sulphate of morphia, nux vomica (dogbane), oxide 
of zinc, gallic acid, sulphate of quinia, laudanum, Hoffman's 
anodyne, black drop, essence of peppermint, essence of spear- 
mint, essence of pennyroyal, ginger-tea, compound spirit of 
lavender, compound tincture of cardamom, oil of turpentine, 
bleeding (in some cases largely), camphorated tincture of opi- 
um, oil of horsemint, lemon juice, common salt, epsom salt, 
cinnamon, brandy, spiced brandy, spiced wine, sparkling 
wines, extract of belladonna, sulphite of soda, strong tea, 
coffee, citrate of caffein, cologne water, cider, and arsenite of 
potassa. 

The list may seem very formidable at the first count, but as 
the remedies are all directed against the symptoms, or effects, 
and none of them against the causes, and as the symptoms of 
dyspepsia, in all of its multitudinous forms and incidental 
affections, embrace the whole range of pathological phenome- 
nology, the list might be extended to the two thousand reme- 



86 DYSPEFSIA. 



dies of the drug materia medica, as well as limited to one or 
two hundred — provided always, that drugs are the proper 
remedies for dyspepsia. 



CHAPTER XL 
SPEClAIi CAUSES OF DYSPEPSIA. 

It is true, as a general proposition, that whatever impairs the 
health of the whole system or any part of it, conduces to the 
condition of defective nutrition termed dyspepsia. But there 
are many agents and influences which seem to derange the vital 
organism more prominently or more immediately in the primary 
nutritive function, which may properly be treated of as the spe- 
cial causes of dyspepsia. It is these agents and influences 
which are enumerated, more or less in detail, in medical 
books, as causes of dyspepsia. 

The special causes of dyspepsia are more comprehensively 
and clearly stated by Dr. John Mason Good ("Study of Medi- 
cine/') than in the writings of any later author with which I 
am acquainted : 

" The common causes, whether confined to the stomach, or 
co-extensive with the associate viscera, may be contemplated 
under two heads, local and general. The local remote causes 
are, a too large indulgence in sedative and diluting substances ; 
as tea, coffee, and warm water, or similar liquids taken as a 
beverage ; or an equal indulgence in stimulant and acrid mate- 
rials, as ardent spirits, spices, acids, tobacco, whether smoked 
or chewed, snuffs, a daily habit of distending the stomach by 
hard eating or drinking ; or a rigid abstemiousness, and very 
protracted periods of fasting. The general remote causes 
are, an indolent or sedentary life, in which no exercise is afford- 
ed to the muscular fibres or mental faculties. Or, on the other 
hand, habitual exhaustion from intense study, not properly 
alternated with cheerful conversation ; becoming a prey to the 
violent passions, and especially those of the depressing kind, 



SPECIAL CAUSES OF DYSPEPSIA. 87 

as fear, grief, deep anxiety ; immoderate libidinous indulgence, 
and a life of too great muscular exertion. Perhaps the most 
common of this latter class of causes are, late hours, and the 
use of spirituous liquors. " 

There is one prolific cause of indigestion, and of those most 
distressing complications, obstinate constipation, pile tumors, 
prolapsus of the lower bowel, fistula in ano, and fissures in the 
rectum, which medical authors do not mention, although some 
of them allude to it as among the general causes of indigestion. 
I mean purgative or cathartic medicine, regular or irregular. 
Torpid or inactive bowels is so nearly a universal condition in 
civilized society, that purgative medicine of some kind is gene- 
rally regarded as necessary as is food or drink. And people 
generally regard them as among the most innocent, or at the 
most, the least injurious of the various classes of medicines. 
It is a disastrous mistake. Bad as liquor and tobacco are, 
purgatives are much worse. A majority of persons may take 
an ordinary drink or dose of rum, brandy, gin, or whisky, three 
times a day with less injury to the health, than are doses of 
jalap and cream of tartar, senna and salts, castor oil, or any of 
the multitudinous aperient, purgative, bilious, or anti-bilious 
pills th it are swallowed by hundreds of tons annually. 

It is well known to physicians that the habitual employment 
of purgative medicines of any kind, however much it may 
relieve temporarily, never fails to aggravate constipation in 
the end. I have had patients to treat whose bowels, after being 
pilled for a few years, would not move without special attention, 
once a week. In one instance a patient came to me from 
Europe to be treated for constipation. He had taken cathar- 
tics regularly for a dozen years, and his bowels were so devital- 
ized that, during a fifteen days' passage across the Atlantic, his 
bowels did not move at all, nor did he experience the least indi- 
cation in that direction. Women suffer more than men of 
purgative medicines because their more sedentary habits seem 
to require larger doses or more frequent repetitions. 

The late Professor William Tully, M. D., of Yale College, 
said to his medical class that more injury was done by the 



88 DYSPEPSIA. 



injudicious use of cathartics, by the regular profession, as a 
whole, than by all other classes of medicines. 

The late Professor Robley Dunglison, M. D. , m his work 
"Therapeutics and Materia Medica," denounces the prevalent 
employment of cathartics by physicians in no measured terms; 
and he quotes (Vol. I. page 176,) the eminent Dr. Stokes, of 
London, with regard to their use in fevers, as follows : 

"A common practice has prevailed in these countries, and 
indeed, still exists to a very great extent, of making the patient 
take purgative medicine every day ; and this, I regret to say, 
is too often done even in cases where the surface of the small 
intestine presents extensive patches of ulceration. Now, I will 
ask you, can anything be so barbarous as this, or can it be ex- 
ceeded in folly or mischief by the grossest acts of quackery ? 
Here we have an organ in a state of high irritation, and exhib- 
iting a remarkable excitement of its circulation, and yet we 
proceed to apply stimulants to that organ, and to increase the 
existing irritation. Would it not be absurd, in a case of in- 
flammation of the knee or elbow-joint, to direct a patient to 
use constant exercise and motion ? Would it not be a very 
strange practice to apply irritants to a raw and excoriated sur- 
face ? Yet something equally absurd and equally mischievous, 
is done by those who employ violent purgatives in a case of 
inflammation of the digestive tube in fever. This has been a 
great blot in the history of British practice. Calomel and black 
bottle, and even jalap and aloes, and scammony, have been 
prescribed for patients laboring under severe and extensive 
dothinenteritis. Morbid stools are discharged, and the more 
morbid they are, the more calomel and purgatives does the 
)hysician give to change their character, and bring them back 
,0 the standard of health. I want words to express the horrible 
consequences. Too often have I seen fever patients brought 
into the hospital with diarrhoea, hypercatharsis, and inflamma- 
tion of the mucous membrane from the use of purgatives 
administered before their admission. Practitioners will not 
open their eyes. They give purgatives day by day, a very easy 
practice, and one for which there are plenty of precedents ; but 



SPECIAL CAUSES OF DYSPEPSIA. 89 

it is fraught with most violent consequences. I will freely admit, 
that the disciples of the school of Broussais have gone too far in 
decrying the use of laxatives altogether. But if they have lost 
hundreds by this error, British practitioners have killed thousands 
by an opposite plan of treatment. In cases of fever where 
there is no decided symptom of gastro-enteric disease, there 
can be no objection to the use of laxatives, if required, but they 
should always be of the mildest description. You will gain 
nothing by violent purging in fever ; mild laxatives alone can 
be employed ; and where there is any sign of intestinal irrita- 
tion present, even these should be used with caution. There 
is one mode of opening the bowels, which you may always have 
recourse to with advantage in fever, viz., the use of enemata. 
There is not the slightest doubt that, occasionally, accumu- 
lations of fecal matter will take place, and tend to keep up irri- 
tation, but they should always be removed with the least pos- 
sible risk of producing bad consequences. To purge in fever 
when intestinal irritation is present, is a practice opposed alike 
to theory and experience, and I have already stated that its 
results are most horrible." 

All the reasons which Dr. Stokes presents so forcibly against 
the employment of cathartic drugs in fevers, applies with still 
greater emphasis against their employment in dyspepsia, for the 
reason that, in fevers, the points of irritation are more diffused 
throughout the system, whereas in dyspepsia they are more 
concentrated along the tract of the alimentary canal. 

The late Professor Charles A. Lee, M. D., in some editorial 
notes to Copland's Medical Dictionary, pages 385 and 3%6 y 
makes a fearful and yet most truthful statement of the pills and ^ 
other causes now in operation to extend and perpetuate dyspep- * 
sia among the people of the United States. There is food for 
reflection in the following paragraphs : 

/'Dyspepsia is, comparatively, a modern disease in our 
country, having been scarcely known until within the last thirty 
years (1846). Our ancestors, as stated by an accurate 
observer, were accustomed to much bodily exertion ; there 
were but few pleasure or wheel-carriages in the country ; both 



go DYSPEPSIA. 



males and females generally rode on horseback ; professional 
men almost universally had farms, on which they labored more 
or less ; merchants were also frequently engaged in mechanical 
pursuits ; the habits of living were simple and frugal ; intoxi- 
cating liquors were seldom drunk ; religious excitements, so 
destructive to the health both of body and mind, were almost 
unknown ; regular and natural hours of sleeping and eating 
were observed ; and these circumstances proved highly propi- 
tious in securing the general enjoyment of bodily health and 
mental vigor.* These salutary habits, however, have been 
gradually exchanged for those of a more unnatural and injuri- 
ous tendency ; bodily labor, carried to the point of fatigue, is 
now deemed degrading, if not decidedly vulgar ; languishing 
in easy carriages has succeeded to equestrian habits and equita- 
tion ; professional men confine themselves to the legitimate 
business of their calling ; excitements of every kind, civil, 
political, religious, mesmeric, are the order of the day ; habits 
of luxurious living have become general ; alcoholic drinks 
are more extensively used than formerly, although a great 
improvement has taken place within the last few years ; the 
almost universal practice prevails of using tobacco in some form; 
habits of inactivity, tight-lacing, keeping late hours, &c, are 
gradually undermining the health of the female sex, and lay- 
ing the foundation of gastric affections ; and all these causes, 
with numerous others that might be named, are slowly deteri- 
orating the health of the community, and their effects are 
likely to become still more evident and distressing in the next 
and succeeding generations. " 

How fearfully the prediction has been realized, as any one 
may see in the skeleton forms, gaunt abdomens, caved-in 
chests, projecting shoulders, wan complexions, dyspeptic walk, 
and consumptive look of the fashionable young ladies and 
gentlemen who promenade the thoroughfares of our great 
cities. Of the pill business, Professor Lee says : 

" Another very prominent cause of the prevalence of indi- 

* "A Dissertation on Chronic Debility of the Stomach, by Benjamin Wolsey Dwight, 
in Memoirs of the Connecticut Academy of Arts and Sciences. New Haven, 1811." 



SPECIAL CAUSES OF DYSPEPSIA. 9 1 

gestion in this country is the excessive use of cathartic medi- 
cine in the form of pills. Were we to give the amount of the 
latter annually swallowed in the United States, the statement 
would not be believed ; and yet we have it from good authority, 
namely, that of the manufacturer himself, that one establish- 
ment in the city (New York, ) turns out, by the aid of steam, 
no less than .ten barrels per day, and this is by no means so 
extensive as some others of a similar kind. These pills, which 
are highly drastic, are used by immense numbers of people, 
not only incases of actual illness, but in time of health, as 
prophylactic remedies. The consequences are easily predicted. 
In addition to this, great quantities of bitters are used, in 
which brandy, wine, or some alcoholic liquor forms the princi- 
pal ingredient ; and on the occurrence of the least feeling of 
discomfort, recourse is had to the panacea, till at length the 
powers of the stomach are exhausted, and derangements either 
functional or structural take place. We could wish that the 
epitaph of the Italian count could be placed so as to be seen 
by every man, woman, and child : ' / was well — wished to be 
better — took physic, and died. ' 

" Much of this evil is doubtless owing to physicians, who have 
been too much in the habit of pouring down drugs empirically 
in every case of illness, slight or severe, in order to humor a 
popular notion that the materia medica must furnish a remedy 
for every disease, and a popular prejudice that want of success 
is a sure indication of poverty of resource on the part of the 
practitioner. " 

A little figuring will give us a more realizing sense of the 
extent to which the people are pilled. Our population has 
doubled since Dr. Lee wrote the above, and pill-makers have 
multiplied ; and as there could not have been less than half-a- 
dozen establishments in a single one of our cities, manufactur- 
ing each ten barrels per day, the quantity now made daily can- 
not be less than one hundred barrels per day ; and then Phila- 
delphia does^an extensive business in the same line, as do 
Boston and other cities. But, reckoning the pills turned out 



92 DYSPEPSIA. 



in the city of New York alone, let us see how the matter 
stands, Pills vs. People. 

A barrel of pills will weigh about as many pounds as a bar- 
rel of pork, and a pill of average size three and a half grains. 
From this data the expert in arithmetic may soon ascertain that 
the good people of this enlightened nation are provided with 
the bowel-moving agencies of fifteen billion nine hundred and 
ninety-one million, six hundred thousand individual pills annu- 
ally. But our statistics thus far represent only the irregular 
trade. If we add the pills orthodoxically prescribed, we may 
swell the amount to twenty billions — two billions of pills for 
each million of our population, or five hundred pills for every 
man, woman, and child. And yet our ciphering is not com- 
plete. Young children cannot swallow pills ; there are 
Homoeopathists who do not believe in them, and Hygienists 
who never take medicine of any kind ; hence a nice calculation 
may allow the actual pill-takers about one thousand a year each, 
averaging within a fraction of three pills per day. How long the 
human stomach and bowels can stand this pill-trade is, like 
the problem of the final consummation of all things, only a 
question of time. The fact that our people " still live " under 
it, is a sufficient demonstration that ''humanity is tough." 
Such a treatment of our domestic animals would exterminate 
them in a single generation. 

In a late work on Indigestion, by Arthur Leared, M. D., 
extracts from which appear in the Popular Science Monthly for 
May, 1872, the following remarks are made in relation to the 
most prominent causes of dyspepsia : 

"At all stages of adult life, but particularly during its 
decline, the appetite is over-stimulated by condiments, and 
tempted to excess by culinary refinements. Dyspepsia is not 
the worst result of this. Gout, and still more serious mala- 
dies connected with an impure state of the blood, closely 
follow." 

"Two habits, smoking and taking snuff, require special 
notice as causes of dyspepsia. Excessive smoking produces 
a depressed condition of the system, and a great waste of 



SPECIAL CAUSES OF DYSPEPSIA. 93 

saliva, if the habit of spitting is encouraged. I have met some 
severe cases of dyspepsia clearly resulting from these causes. 
Some individuals are unable to acquire the habit of smoking 
even moderately. Deadly paleness, nausea, vomiting, inter- 
mittency of pulse, with great depression of the circulation, 
come on whenever it is attempted. But this incapacity is 
exceptional, and so universal is the desire for tobacco, that it 
seems as if some want of the system is supplied by its use. " * 

What is the ' ' excessive " use of tobacco, or any other 
poison ? One might as well talk of excessive lying, or excess- 
ive stealing, as though moderation in these habits might be 
judicious, or necessary ! Nor does the great number that 
have depraved their instincts and become addicted to tobacco- 
using, make the vice a virtue. As well might the general 
prevalence of gambling or prostitution, in any given locality 
(Wall Street, Five-Points), be adduced as the evidence that 
gambling, or prostitution supplied some want of the system. 
And, verily, it does. But it is the craving of a demoralized 
mental or a debauched physical nature. 

It seems quite impossible for a modern medical author to 
write anything about tobacco or alcohol without doing it with 
the " modern improvements " of logic. He knows they are 
bad. He knows the people are very much addicted to them. 
He cannot stultify himself by saying they are not injurious. 
He cannot stultify his business by saying they are wholly evil, 
and that continually. And so he compromises by condemn- 
ing their excessive and commending their moderate employ- 
ment, leaving his readers to find out where moderation ends 
and excess begins — in the grog-shop, the gutter, or the drunk- 
ard's grave, if they can. 

Winslow's Soothing Syrup. 

Perhaps no single quack nostrum is doing more mischief in 
our country at this time, in deranging the digestive organs of 
infants, paralyzing their nerves, stupefying their intellects, 
and laying the foundation for dyspeptic miseries and mental 



94 DYSPEPSIA. 



imbecilities in later life, than this pernicious opiate. The 
Druggists Circular says : 

"Mrs. Wixslow's Soothing Syrup has several limes been 
condemned in the columns of The Druggists 7 Circular, but 
we have not published the formula. The original recipe is 
kept secret, but the results of analysis have been made known. 
It has been shown that one ounce of the syrup contains one 
grain of morphia. If, then, Mrs. Winslow's instructions be 
followed, the dose for an infant three months old contains an 
equivalent of ten drops of laudanum, and this Mrs. Winslow 
recommends to be repeated every two hours ! The injury that 
may be done by the ignorant use of such a nostrum is hardly 
to be estimated ; and yet a calculation has been made that not 
less than fifteen million ounces of the syrup are annually sold 
in the United States ; in other words, that the children of this 
country are dosed every year with as many million grains of 
morphia !" 



CHAPTER XII. 
SYMPTOMS OE DYSPEPSIA. 

As already stated, the symptoms of dyspepsia are as numer- 
ous and as complicated as are morbid conditions and abnormal 
sensations. In number and severity they vary infinitely, some 
dyspeptics being able to attend to their ordinary business and 
duties, and only experiencing occasional pain or distress in the 
stomach or auxiliary digestive organs, while others are unable 
to do anything but dwell despondently on their miserable feel- 
ings, and are, indeed, as wretched as human nature can bear 
and live. 

The symptoms attending the more important phases of the 
disease have been explained in connection with the organs and 
structures to whose special functional disturbance they are 
more particularly referable, in the first part of this work. I 



SYMPTOMS OF DYSPEPSIA. 95 

will only add the description of Dr. Good, whose admirable 
work, though not now a text-book in our medical colleges, is 
a vastly more useful work for the medical student or the non- 
professional reader, than any work on the Theory and Practice 
of Medicine that has appeared since. 

" Dyspepsia may be regarded as consisting of the combina- 
tion of several morbid conditions irregularly intermixed ; 
sometimes one set of symptoms taking the lead, and some- 
times another ; with a peculiar tendency to costive bowels, and 
especially that species of costiveness dependent on a weakly 
temperament or a sedentary habit, and in which the discharged 
fceces, instead of being congestive and voluminous, are hard, 
slender, and often scybalous. Dyspepsia, therefore, in the 
language of Dr. Cullen, may be described as a want of appetite, 
a squeamishness, sometimes a vomiting, sudden and transient 
distentions of the stomach, eructations of various kinds, heart- 
burn, pains in the region of the stomach, and a bound belly. 
Yet none of these are universally present, and all of them 
seldom. So that, as already observed, the symptoms of car- 
dialgia, flatulence, and vomiting, with a few others, enter in 
irregular modifications into dyspepsia, as those of dyspepsia 
enter into hypochondriasis. 

" There is also another complaint which frequently enters 
into the multiform combination of maladies, of which dyspep- 
sia is the general expression, and which has been rarely noticed 
by writers, although it is often a very troublesome symptom, 
and that is gravel. In treating of gravel, or lithia, as an 
idiopathic affection, we shall have to notice that one of its 
chief and most common causes is an excess of acidity in the 
prima vice; and, as such excess is almost constantly to be 
found in dyspepsia, gravel must frequently attend or follow, 
and is even a necessary effect where there exists what has been 
called a calculous diathesis. And, for a like reason, where 
there is a podagric diathesis, gout, in some form or other, is a 
frequent concomitant. " 

"In dyspepsia the debility is not often confined to the 
stomach, but extends to the intestinal canal, and the collati- 



96 DYSPEPSIA. 



tious viscera, as the mesentery, the spleen, the pancreas, and 
especially the liver, in which it most frequently commences ; 
and hence another cause of the great complexity of this disease." 

"The debility, and indeed torpitude of the intestinal canal, 
is evident from the habitual costiveness which so peculiarly 
characterizes this affection. Whether this be direct or indirect, 
intrinsic or sympathetic, as harmonizing with the weakness of 
the stomach, it is not easy to determine ; but nothing can be 
a stronger proof of the great inactivity of the intestinal tube, 
from whatever cause produced, than the feebleness of its 
peristaltic motion, notwithstanding the acrimonious matters 
that are so frequently diffused over its inner surface." 

** The imbecility of the liver is equally obvious in most 
vcases, from the small quantity of bile that seems to be excreted, 
or its altered and morbid hue, as evinced by the color of the 
fceces, which, in some instances, are of an unduly dark, and 
in others of an unduly light tint ; and possibly from the inac- 
tivity of the intestines themselves, whose peristaltic motion is 
conceived by Dr. Saunders and other pathologists to be, in a 
great measure, kept up by the stimulus of the bile. " 

"When the mesentery is affected the chyle is generally 
obstructed in its passage to the thoracic duct, and the general 
frame, deprived of its needful nutrition, becomes flaccid and 
emaciated ; and from a collapse of the minute vessels on the 
surface, assumes a wan or sallow complexion." 

"It is highly probable that the pancreas and spleen are 
both also affected in many cases of dyspepsia. Of the actual 
part taken by either, in the process of digestion, we know but 
little ; but we do know that the pancreas pours forth a con- 
siderable portion of the fluid which holds the solid part of our 
aliment in solution ; while in most of the cases of dyspepsia 
brought on by a habit of drinking spirituous liquors, the spleen 
is evidently affected as well as the liver." 

■" It is in this stage of the disease that we frequently meet 
the tenderness or other uneasiness in the epigastric region, and 
that peculiar hardness of the pulse, often accompanied by 
febrile symptoms, which Dr. Wilson Philip has pointed out 



SYMPTOMS OF DYSPEPSIA. 97 

as pathognomonic of what he calls a second stage of the dis- 
ease. " 

"It has also been well observed by Dr. Philip, that the 
lungs are, in many instances, apt to associate in the morbid 
action of the digestive organs, when it has become chronic, 
and to produce, as a result, a peculiar variety of consumption, 
to which he has given the name of dyspeptic phthisis. The 
dyspeptic character of the disease, however, and especially the 
hepatic symptoms, together with those of lowness of spirits, 
flatulence, and other hypochondriacal affections, rarely fail to 
accompany it when complicated with phthisis, and point out 
its real source ; and the cure must be chiefly directed to the 
primary malady, how much soever the induced symptoms may 
also demand our attention ; for it will be in vain to subdue the 
latter, while the former is still suffered to bear sway." 

"It must nevertheless be admitted, that in some instances 
the secondary disease seems to afford relief to the primary, and 
that the organ first affected recovers its health in proportion as 
that subsequently affected yields to the attack ; in the same 
manner as, in erysipelas and the migratory forms of herpes, 
the eruption travels forward, the part relinquished heals, and 
fresh parts are affected in succession. In all such cases, the 
secondary complaint becomes a new malady, and must often 
be followed up under another principle and another mode of 
treatment. " 

* ' Under whatever form, and from whatever cause the disease 
occurs, there is a considerable degree of general languor and 
debility. Exercise or exertion of any kind soon fatigues ; the 
pulse is weak ; the sleep disturbed ; the extremities are cold, 
or rendered so on slight occasions ; and the tongue for the 
most part is fussed, or covered with a creamy mucus in the 
morning. Yet this last symptom is not always to be depended 
on ; for it is sometimes wanting in the disease. " 

" That dyspepsia should be connected with a morbid con- 
dition of any of the adjoining organs, is by no means difficult 
to conceive, when we reflect that they are all concerned, directly 
or indirectly, in completing the great object of the digestive 



98 DYSPEPSIA. 



process, which is that of furnishing a constant supply of nutri- 
tion for the system at large." 

Not half a century ago, it became a fashion with some 
physicians, in obscure and complicated cases of indigestion, 
when diagnosis was dubious and prognosis impracticable, es- 
pecially after the patient had "suffered many things of many 
physicians," to request the patient to make a written list of his 
symptoms, as they occurred from day to day. But it was found 
to work like Homoeopathic * ' provings. " If the experimentee 
swallow an inappreciable particle of preparata creta, diluted in, 
diffused through, or potentized by, ten thousand trillion times 
its bulk or weight of water, he may count five, fifty, five hun- 
dred, or five thousand "symptoms," according to the time 
and attention that he will give to the subject. So with these 
miserable dyspeptics, made more miserable by the miserable 
business of thinking of their miseries. There was no end to 
their miserable and ever changing sensations. The moment 
a confirmed dyspeptic undertakes ' ' to see how he feels, " and 
make a record of his morbid sensations, he can always have a 
day's work before him. He can write down symptoms day 
after day, ' ' from the rising of the sun to the going down of 
the same," besides dreaming of them half the night. That 
inimitable lithograph of equine pathology, on sale at the horse 
bazaars, denominated ' ' The Horse with all Diseases, " whose 
deformed body, distorted joints, dilapidated surface, abrasions, 
swellings, ulcers, and emaciation represent sixty-four distinct 
maladies, does not indicate more phenomenology than almost 
any dyspeptic, who has been cured half a dozen times, can 
count if you give him time enough. 

Many febrile patients are drugged into chronic diseases, 
which invariably present some one or more of the numerous 
phases of dyspepsia ; and many of the worst symptoms of 
which most dyspeptics complain, are nothing more nor less 
than the effects of the medicines they have taken. Women, in 
this respect, suffer much more than men do, for the reason that, 
being more dyspeptic, they are doctored more. The following 
remarks, quoted from my work on "The Health and Diseases 



SYMPTOMS OF DYSPEPSIA. 99 

of Women," published at the Health Reformer office, Battle 
Creek, Michigan, will apply, with some qualification, which 
the reader will readily appreciate, to men as well as women : 

"Drugging during Pregnancy. — But if the woman escapes 
with dear life the ailments incident to puberty, other perils are 
before her. In the common order of events, the matrimonial 
relation is formed. Then come child-birth and nursing, with 
all their joys and sorrows. Lucky is the woman who can, on 
these occasions, escape the doctor's lancet and drugs. During 
pregnancy, she usually suffers more or less of nausea, cramps, 
constipation, vertigo, etc. , for which she is bled, physicked, and 
narcotized, predisposing her to hemorrhage, milk-leg, broken 
breast, and other sequela, and multiplying the occasions for 
taking more medicines. 

"Drugging during the Lying-in Period. — After confine- 
ment, the majority of women are troubled (and no wonder) 
more or less with indigestion, constipation, sour stomach, flat- 
ulence, sore mouth, sick headache, etc. , for which chalk, soda, 
saleratus, magnesia, lunar caustic, bismuth, blue pill, etc. , are 
prescribed. And now the medicines are doing a double work 
of mischief. The drugs which she is continually taking into 
her system, under the name of medicine, deprave the blood, 
vitiate all of the secretions, and poison the very fountain 
whence the new-born being derives its nourishment 

"These drug poisons must be expelled. The living system 
gets rid of them through every available channel. And that 
portion which passes off with the milk often destroys the life of 
the nursing infant, or renders it a puny, feeble thing for life. 
So much for the child. It must be at all times liable to can- 
ker, colic, humors, rashes, convulsions, and death, so long as 
its mother is continually taking into her system that which con- 
taminates and impoverishes the only source of its subsistence. 

"Chronic Drug Disease.— But if the mother survive the 
terrible ordeal which a false medical system imposes on her, 
there is yet trouble enough in the future. The dosings of 
infancy, the druggings of puberty, and the poisonings of her 
maternity, have laid the foundations for innumerable and name- 



IOO DYSPEPSIA. 



less chronic diseases; and now these must be doctored secundem 
artem. And thus medical science has laid the foundation for 
an extensive practice in the healing art — provided the patient 
lives long enough. 

In due time the woman comes to be regarded as a confirmed 
invalid. And no sooner is she ' ' cured " of one malady, than 
another ' ' sets in. " - 

How strange that some new disease is always ready to 
" supervene " so soon as the existing one is "subdued !" Her 
aches and pains, and "sinking spells," and flutterings, and 
gonenesses, and short breathings, and palpitations, and dragging 
sensations, and nervousness, require, in the judgment of the 
family physician, a course of tonics, nervines, and stimulants, 
and quassia, carbonate of ammonia, assafetida, castor, musk, 
valerian, spices, aromatics, phosphate of iron, or iron-by-hy- 
drogen, wine, brandy, porter, ale, lager beer, etc. , etc. 

She is also put on the medico-slop diet of the pharmacopoeias 
— fed on such delicate abominations as panada, starch pud- 
dings, beef tea, mutton broth, oyster soup, chicken gravy, 
buttered toast, and sugar nick-nacs. In a word, instead of 
being nourished and strengthened, she is merely stuffed and 
stimulated. 

All this makes a bad matter worse; and at length the doctor, 
having treated the general dyspeptic condition for a few months, 
or a few years, looks a little deeper into the case, and finds out 
that the patient has a torpid liver. Then come calomel and 
opium, perhaps blue pill again, to "touch up" the hepatic 
function, with henbane, or conium, or morphia, to quiet the 
irritation. 

Well, in due time the torpid liver is " cured," or its action 
so depressed that it ceases to make any further resistance to the 
medicines, and now the doctor discovers that jaundice has i ' set 
in." Verily it has. And the drugs are just what have set 
it in. 

But this jaundice must be "treated ;" and so the persevering 
physician doses it, or the patient, with a combination of " alte- 
ratives " — antimony, hydriodate of potassa, yellow dock, bitter 



SYMPTOMS OF DYSPEPSIA. I Of 

sweet, blue flag, mandrake, black cohosh, corrosive sublimate, 
iodine, and arsenic. 

And thus another set of poisons are sent into the vital do- 
main, with the inevitable result of another set of drug diseases. 

Soon, another diagnosis is made, and the disease is pro- 
nounced kidney complaint. This is medicated with leeches, 
cuppings, salts, antiphlogistics, diuretics, alkalies and counter 
irritants, and the next phase of the malady is said to be nervous 
debility. And again the patient must be put on tonics, stimulants, 
and nervines, as lunar caustic, phosphorus, ammonia, extract 
of hops, cascarilla, myrrh, hypophosphites, preparations of 
iron, camphor, ether, spirits of nitre, compound spirits of la- 
vender, golden seal, unicorn, wormwood, thoroughwort, skunk 
cabbage, etc., etc. 

When the sensibility of the nervous system is sufficiently 
subdued, the nervous debility is as subdued also. The disease 
is "cured/' though the patient is nearly killed ; but no sooner 
is the cure achieved than (how unfortunate ! ) still another dis- 
ease "supervenes." Now the muscular system gives out ; the 
back becomes weak, and the limbs tremulous. The kind and 
ever-faithful physician now diagnosticates spinal irritation. Still 
he is not without hope for his patient. The resources of his 
art are immense. There are in the apothecary shop at least 
one thousand drugs which he has not yet administered, and 
there are numerous processes which he has not yet brought 
into requisition. Why should he be discouraged ? So long as 
there is life there is hope — at least of making a bill. 

Blistering, cupping, leeching, scarifying, pustulations, cau- 
stics, issues, setons, moxa burnings and the actual cautery, are 
the scientific remedies for spinal irritation. 

The marring, and scarring, and haggling, and mangling, 
finally overcome the spinal irritation, and then we come to the 
end of the chapter, which is neuralgia. 

Neuralgia is regarded as incurable. But there is one conso- 
lation — there are no more diseases to ' ' set in. " The patient 
has got below the range of their action, and hence cannot be 
*' attacked " by them. Her vitality is too low to respond to 



102 DYSPEPSIA. 



morbific causes, hence they may remain in her system without 
any special effort to get rid of them. She cannot, therefore, 
have any particular disease known to the nosology, but she 
can be very wretched. 

The doctors can cure almost everything except neuralgia. 
We have seen how effectually they cure dyspepsia, liver com- 
plaint, jaundice, kidney disease, nervous debility and spinal 
irritation, but neuralgia is peculiarly a " medicorum oppro- 
brium." Yet medical science does not wholly despair, it can 
still " alleviate the symptoms. " For what did "nature pro- 
vide " morphine, quinine, stramonium, belladonna, prussic 
acid, veratria, aconite, chloroform, digitalis, henbane, ratsbane, 
dogsbane, fleabane, and all the banes, venoms and viruses, all 
the drugs and die stuffs, and dregs and scum of the mineral, 
vegetable, and animal kingdoms, except to quiet pain ? And 
so long as the poor patient is dosed with narcotics and de- 
pressants below the point of susceptibility, she may be kept 
oblivious of misery. Has not medicine been entitled the art 
divine? I fear the Irish doctor was not far wrong when he 
presented a bill to his wealthy neighbor : "To curing your 
wife till she died. " 

And now after medical skill has done its best, or its worst, 
surgical ingenuity exhausts itself in vain efforts to repair the 
damages occasioned by bad living and worse doctoring. The 
uterine organs become permanently congested, relaxed, and 
debilitated, ulcerations occur, excrescences form, and displace- 
ments result. 

These are treated indiscriminately with astringents, caustics, 
pessaries, braces, leechings, scarifyings and burnings, which, 
although in some cases temporary relief is obtained, never fail . 
to aggravate the difficulties in the end. 

Induration, paralysis, fistulous openings, extensive inflam- 
mations, permanent adhesions, fungous excrescences, and can- 
cerous ulcerations, are among the frightful catalogue of evils 
which result from these attempts to give " mechanical support" 
to the displaced viscera. 

Not long since, I had a patient under treatment for erosive 



SYMPTOMS OF DYSPEPSIA. 103 

or cancerous degeneration of the uterus, the consequence of the 
prolonged employment of pessaries. And a few years ago, I 
was consulted by a lady who had a fistulous ulcer opening ex- 
ternally from the bowels, just below the umbilicus, through 
which the fecal matters were discharged, produced by wearing 
an "abdominal supporter." 

A few years ago, I visited a young lady in Philadelphia who 
had been a bed-ridden invalid for fifteen years, in consequence 
of a retroversion of the womb. Her father was wealthy and 
had employed the most eminent physicans and surgeons of that 
doctor-making city, who had invented a bureau drawer full of 
"supporters " for the displaced organ ; and they had ' • toned her 
up " with tonics, and ' ' quieted her down " with nervines, and 
nourished her on ' ' blood-food " preparations of iron, until her 
muscular system was as flimsy as a wet rag. And these are but 
examples of hundreds whose cases have come under my ob- 
servation and treatment 

I cannot pursue this branch of my subject here. Those who 
would have fuller information are referred to my larger works, 
"Pathology of the Reproductive Organs," and "Uterine 
Diseases and Displacements." The limits of this work will 
only enable me to show the errors and absurdities of the 
prevailing medical system, and indicate "the better way." 

As future generations may prosper or must perish, just as 
the mothers of the race maintain or lose their vital stamina, I 
cannot forbear copying the following appeal to Christians, 
from that excellent monthly, The Christian Monitor. It ought 
to be distributed as a tract in every Sunday-school in the land : 

THF PRIME CAUSES OF WOMAN S SUFFERINGS. 

% 

BY JOSSI ANN MAL 

The principle of progression in human nature furnishes the proposition 
"that it is not the goal, but the course which makes us happy " — not so 
much the possession of an object as the pursuit that gives pleasure. If this 
is true, it is also true, that a consciousness that one's course will not secure 
the object sought, will incur great discomfiture and its consequent evils ; 
for while the attainment of earthly prizes do not satisfy, they lure us on, 
compensating and withholding in advance according to the course. Life is 
a repetition of causes and effects, of efforts and rewards, _ or punishments, 



IC4 DYSPEPSIA. 



which are but the tiny ripples of its sea, that must widen and extend into 
corresponding shapes in the great ocean "of eternity for all its possessors. 

We do not advocate the doctrine, that a man's temporal life on earth, 
antetypes his employment in heaven ; but we do believe that the degree of 
moral power possessed here must characterize, at least his infancy, in the 
world to come. "In the place where the tree falleth there it shall lie." 
" He that is unjust let him be unjust still ; he that is holy, let him be holy 
still." " My reward is with me to give to every man according as his work 
shall be." 

Therefore when one has enumerated to himself from infancy to old age 
the fruit, which should be the perpetual outgrowth of his nature in order to 
obtain the eternal meet awarded to Christians, and finds himself failing, 
and refailing, in his efforts to produce them, it discourages and demoralizes; 
and in many persons produces their descent into the depths of immorality; 
others, perhaps, more hopeful and persevering in their natures, press on, 
but suffer material demoralization, by a recognition of the result, which 
may come of the knotty, wormy, imperfect fruits, which are the issues of 
their life. 

Not unfrequently have I met women who have assured me, m the grief 
and agony of their souls, that they would be good, and subdue their exci- 
table, passionate dispositions, if they could. They had married with bright 
hopes, and the determination to live useful, noble lives; had been obliged 
to work hard, with no time for mental cultivation; their husbands had gone 
on from one degree of improvement to another, until they were no company 
for each other; which is always heart-rending to a sensible woman; child- 
ren had come fast and were growing up disobedient and untrained ; they 
felt responsible for it, for their course had been unsteady, fretful and pas., 
sionate; they had tried again and again to be firm, kind and judicious; 
but ere they were aware of it, would find themselves, m a fit of anger, shorn 
of their strength. And so they had come to the conclusion that "They 
could not be good and there was no use of trying.* ' 

But what is the cause of all this ? Effect must have cause. Two items 
furnish the causes — one the primary, the other, the secondary. First, an 
unwholesome training in youth — when, if that sublime injunction, " Know 
thyself" had been obeyed, by a study of the mental, moral, and physical 
laws of the human being, -^ the importance of obeying them, and the 
strength and power of reason acquired for self-control— accidents and casu- 
alties aside — the secondary, poor health, might have been avoided, and 
the great behest of life nobly and sublimely fulfilled. 

But no — the announcement that a girl babv is born is equivalent to cram- 
ming its head with the rules of etiquette, coquetry, and a fashionable toi- 
lette, instead of anything that would contribute to the magnanimous sym- 
metrical development of the immortal spirit. The instruction is early given, 
"that the one who plays the round of fashionable life the most successfully, 



SYMPTOMS OF DYSPEPSIA. 105 

will bear off the palm of beauty and grace, indicative of woman's highest 
capabilities ; — hence the distorted spine, wasp waist, tiny feet, pale- 
faced, sickly, sentimental, passionate, powerless woman ! All this second- 
arily, the outgrowth of false dressing, excesses and irregularities in eating, 
drinking, sleeping, and slothful inactivity. 

Probably no country furnishes such multitudes of peevish, fretful, nervous 
women as the United States. Who can wonder that one is all worn down 
with nervous debility, and only keeps herself up by stimulants ; another 
afflicted with that terrible disease, nervous dyspepsia, which congests the 
brain, and affects the mind so seriously that an eminent physician has com- 
pared persons thus diseased, to the ancients possessed with evil spirits ; 
another with engorgement of the portal vein and blood-vessels of the liver, 
thus interfering with its depuratory office, and not only clogging up the 
system, but mmd ; another with consumption ; another, diseases peculiar 
to her sex, which have the most direful effect upon the system ; and still 
another with scrofula in some form, creating not only a feverish, excitable 
condition of body, but mind, making its position unreliable. Yes, I say, 
who can wonder that these things are so, if they consider the customs and 
manner of life of women. 

Lacing is the universal practice, and it sometimes seems that all are aim- 
ing at perfection of deformity, if possible. Let one enforce by example or 
word, the importance of a dress reform, and how soon will all unite to show 
their dexterity, in pitching the sarcastic quoits of ignorance at her ; as 
though they would be doing God service if they could cause her to re- 
nounce common sense for the pursuit of disobedience to physical laws, and 
thereby bring on the long catalogue of diseases consequent upon the pres- 
sure of the vital organs — and all this is done to secure false beauty and 
symmetry of form. 

Let us consider the difference in the dressing of a boy and girl. His 
clothing reaches from head to foot, and hand, equally distributed and 
loosely made, which is calculated to induce good circulation and develop- 
ment, from two reasons : — first, there are no bands or corsets to form liga- 
tures of compression and irritation about his body ; — secondly, equality of 
clothing secures equality of warmth, and hence, there are no cold extrem- 
ities deserted of the blood, which must congest in some other part of the 
body. He must wear flannel, wadded coats and vests, with thick- soled 
boots, reaching to the knees, as a protection. How is it with the little 
girl ? Her mother, supposed to be her best friend, will send her out on a 
cold winter day, with one -third the amount of clothing she does her boy. 
Thin shoes reaching just' above her ankle, with one thickness, (a cotton or 
woollen stocking,) reaching to the knee ; two or three thin layers of thin 
cloth over the arms ; perhaps a little more about the waist and shoulders. 
But it would not do to burden her with the amount of clothing the boy 



lo6 DYSPEPSIA. 



wears, or rather, it would prevent the exhibition of the delicate form, which 
the mother had contended for with dame Nature. 

But is this all ? If it were, we might hope for a more speedy recovery of 
woman's health ; for the world is becoming aroused about the necessity of 
a dress reform which is destined to secure improvements at least. I 
believe that one of the greatest evils of woman's life is intemperate eating. 
Her first sin was committed in eating, and we are inclined to think her last 
will be, when we hear Christian women talking like this : — " Do you suppose 
I would deny myself of what I wanted if I knew it would make me sick ? M 
Dear sisters, I pray you, for 'tis to you that I write, not to close your ears 
.to the fact, that our God is a God of justice, and that He would not have 
framed and establislied laws in the human being, without attaching a pen. 
alty to their disobedience ; and that in nine cases out of ten, sickness is 
traceable to over-eating, or the eating of such combinations as would de- 
stroy the stomach of a horse. 

Oh, woman, how can you consciously deprave and vitiate the powers 
which God designed should glorify His name, by the influence of their 
fullest capacity, by being a submissive slave to the lowest passions of your 
nature ? That this is done, is evident to casual observers. Women not 
only glut and gormandize from morning till night, and in some parts of the 
country, eat snuff, and dnnk wine, until perversion is the ruling feature of 
their appetite, but they transmit the disposition to their children, and 
compel them to cultivate it ; for no sooner are the children out of bed than 
they find the indispensable " piece" in their hands, a faithful friend until 
bed-time ; and not unfrequently does it accompany them thither. And 
the only antidote for the cries of a suckling babe, is its "dinner," which is 
seasonable any hour in the twenty four ; unless it cries too hard, when drugs, 
"soothing syrup," "paregoric," etc., become a plus quantity, in some 
cases with a piece of meat, or candy to suck ; for it wouldn't do to deny 
it anything the mother's distorted sympathy supposes it would like. Not 
un frequently these plus quantities, added to the minus quantity, common 
sense and nature's laws, produce a quantity minus its life. Then the 
lamentations of the unhappy parents follow ; only finding consolation in 
the perverted application of the scripture—" The Lord doeth all things 
well." " He giveth and He taketh away." Instead of searching out the 
cause, and learning wisdom from their folly, they persistently pursue the 
same course, until similar results are again produced. 

We sometimes think that no woman should have the care of a family, 
who is unversed in the laws of being, or without the acquisition of self- 
control. The women of one generation, ungoverned by a right knowledge 
of the necessities of physical and spiritual being, and the avoidable causes 
of disease, may commit sin from the effects of which three generations can- 
not recover. 



•SYMPTOMS OF DYSPEPSIA. 107 

The prevalent custom on the part of most women of wearing 
the hair twisted into a mass on the top or back of the head, 
and the more modern and still more pernicious custom of 
loading the head with false hair, or substances resembling it, 
is a fruitful source of headache, and, indirectly, a cause of 
dyspepsia. 

Says a writer in the Science of Health : " And not hair only, 
as if that were not bad enough, but hemp, jute, and coarse in- 
ferior vegetable fibres, must be raised from their native clod, to 
intermingle and be placed on a par with that most unrivalled 
production of nature — the crowning glory of the human form. 
As a matter of health, the subject assumes a more serious 
aspect ; much more so, indeed, than many of our ladies have 
any idea of. Perhaps the most prevalent complaint among 
ladies at the present day is headache ; and we think that care- 
ful investigation will bear us out in asserting that this trouble 
has rather increased than diminished since the present style of 
wearing the hair came in vogue, involving, as it does, the 
loading of the head with such a quantity of foreign material. " 

Ridiculous and silly as is the fashionable head-toggery of 
chignos, frizzles, pugs, etc., the ridiculousness merges into 
the tragical when we consider the inevitably demoralizing 
effects on both body and mind. 

THE HORRORS. 

I will conclude this "chapter of horrors " by copying one of 
several cases which I have published. The case of Mr. Strong 
was published in the Philadelphia Evening Star of October 8, 
1872: 

Written for " The Evening Star." 

The Horrors Depicted. — I do not mean remorse of con- 
science, nor melancholy, nor "dumps," nor "blues," nor 
"hypo," nor what the phrenologist would term " hope small ;" 
but a sense of unmitigated wretchedness disconnected with all 
considerations of conduct or character, good, bad or indifferent, 
and unattended with any outward manifestations of disease. 

It may puzzle the reader to understand how a person can be 



Io8 DYSPEPSIA. 



mentally horrified without being morally bad or physically sick. 
He is sick, but the name of the disease is not found in the 
nosology, nor is there any name or phrase in ancient Latin or 
modern French that will apply to it. It can only be described. 

The patient is in agony all the day, and afflicted with fright- 
ful visions all the night. He is utterly miserable, yet cannot 
tell why. He sees nothing but sources of sorrow in this life, 
and imagines nothing but suffering in the next. Everything 
around him, and all that you say or do, aggravate his misery. 
He sheds no tears, his face is blank and expressionless, he can- 
not laugh nor cry, and he seems to know nothing and care for 
nothing except to feel bad. 

But the rationale of this matter is very simple. It means 
nothing more nor less than a torpid liver with an inactive skin. 
The bile elements are retained in the blood because of tor- 
pidity of that great excreting gland, the liver ; they are not ex- 
pelled through the skin in the form of "humors," because of 
obstruction of that emunctory. The consequences are the 
blood becomes thick, viscid, clogs the internal viscera, and the 
whole volume of circulating fluid is pressed from the circum- 
ference of the body to the centre, and especially upon the brain. 
Why should he not be horrified ? 

Put your finger in a vise, or your body under half a ton's 
weight, and you will have some idea of the pain that can be 
produced by pressure. The felon on the finger, the gout of 
the toes, the rheumatism in the large joints, the boil, and the 
carbuncle are intensely painful only because of the extreme 
pressure consequent on accumulated blood. Let the blood re- 
cede from the surface and accumulate in the brain, lungs, liver, 
and other internal organs, and there will not be acute pain 
locally, but distress generally. Instead of smarting or throb- 
bing on the surface, there is aching and agony all through. The 
sense of misery is too diffused to be imputed to any one organ, 
hence the patient cannot tell where, how, nor why he is dis- 
eased. 

All persons who are distinguished as having a "fine flow of 
animal spirits, " have a free external circulation ; the vessels 



SYMPTOMS OF DYSPEPSIA. I09 

of the skin are well filled ; and so long as this condition is 
maintained the "horrors" can never be experienced. They 
may be sick, afflicted, or unfortunate, but the grief and depres- 
sion will be temporary. It is impossible for such persons to set- 
tle down in gloom and melancholy 

I could mention the name of several persons in New York 
and Philadelphia, who, after being in the horrors for months, 
have recovered their usual good health and spirits, by a little 
hygienic attention to the functions of the skin and liver. I am 
at liberty to mention one, which is typical of all, that of a Mr. 
Strong, produce merchant of Philadelphia, who was treated at 
our "Hygeian Home." 

The horrors in Mr. Strong's case were horrible in the ex- 
treme. He would pace the room or walk the hall continually, 
sighing and groaning as though some terrible calamity was 
impending. Nothing that could be said would comfort him 
in the least. He seemed perversely determined to be as mis- 
erable as possible, and make others so to the extent of his 
ability and opportunity. Yet, poor man, he could not help 
it. The whole cause of all his trouble was within, but he 
fancied it was everywhere else. His imagination was just as 
morbid as his blood, and the very atmosphere was peopled 
with Milton's "devils with devils damned," and vengeful 
deities — the reflections of his own mental state. 

In all of these cases we have only to purify the blood, restore 
the circulation to the surface, and the crushing load within is 
removed, the fiends and demons of the day depart, and the 
ghosts and goblins of the night disappear. As soon as the 
patient is ' ' all right " within himself, the universe becomes all 
right to him. 

Mr. Strong, by means of plain simple food, tepid bathings, 
and active manipulations to the skin, with no medicine of 
any kind, soon began to come to himself, and then all the 
world came to him. He is now attending to business as 
usual. R. T. Trall, M.D. 



IIO DYSPEPSIA. 



CHAPTER XIII. 
DYSPEPSIA AND THE CACHEXIES. 

That nearly all those forms and manifestations of morbid 
conditions which, in medical books, are termed cachexia?, or 
4 ' depraved habits of body/' constituting the peculiar diatheses 
called tubercular, scrofulous, scorbutic, hemorrhagic, pletho- 
ric, dropsical, consumptive, and even entozoic, or verminous, 
are primarily caused by derangements of the digestive processes, 
is becoming more and more the opinion of pathologists. 

In a late work on Pulmonary Consumption, by C. J. B. 
Williams, M. D., F.R.S., of London, who is regarded as the 
first pathologist in Great Britain, if not in Europe, the author 
substantially affirms the doctrine I have all along advocated. 
Dr. Williams is at the head of an extensive hospital and school 
in London ; has had an experience of forty years, and his ob- 
servations are based on a careful study of the data of one 
thousand selected cases recorded in his note-book. The im- 
portance to be attached to Dr. Williams' conclusions may be 
inferred from the following notice of his work by the New York 
Medical Review for January, 1873 : 

" The author of this work needs no introduction to the medical world, 
as his * Principles of Medicine ' is a standard work in both Europe and 
America. As the student of Alison, Laennec, Andral, and Chomel, he 
learned what those distinguished authors had to teach, both at the bedside 
and at the dead-house. The knowledge thus acquired was, for the subse- 
quent twenty years, constantly applied at St. George's and University 
Hospitals, where he attended the wards almost daily, and always superin- 
tended personally the post-mortems. In addition to this, Dr. Williams' 
experience in diseases of the chest in private practice for the last forty 
years, has not been exceeded by that of any other physician. 

"With these facts before us, and the recognized ability of the author, 
we are warranted in expecting an exhaustive and reliable resume of the 
subject under consideration. 

"The author's theory of the pathology of this disease is based on his 
own observations, aided by the recent researches of Lionel Beale, Reck- 
linghausen, Strieker, Cohnheim, Max Scheultzer, and others, in regard to 



DYSPEPSIA AND THE CACHEXIES. HI 

the processes of the living plasma or formative material from which tex- 
tures are produced." 

Dr. Williams indicates his theory of the pathology of con- 
sumption in the following words : 

4 * It is not possible to convey in a few words the views on the nature of 
Phthisis, to which I have been led by observation and reflection on the facts 
and opinions of others as well as my own : but the popular terms decline 
and consumption are the most significant which I can employ to represent 
them. I believe Pulmonary Consumption to arise from a decline or defi- 
ciency of vitality in the natural bioplasm or germinal matter , and this 
deficiency manifests its effects not only in a general wasting or atrophy of 
the whole body, but also in a peculiar degradation, chiefly in the lungs and 
lymphathic system, of portions of this bioplasm into a sluggish low lived, yet 
proliferating matter, which, instead of maintaining the nutrition and integ- 
rity of the tissues (which is the natural office of the bioplasm), clogs 
them and irritates them with a substance which is more or less prone to 
decay, and eventually involves them also in its own disintegration and de- 
struction. This degraded bioplasm, which I will call phthinoplasm (wast- 
ing or decaying forming material), may be thrown out locally, as a result 
of inflammation ; or it may arise more spontaneously in divers points of the 
bioplasm in its ordinary receptacles, the lymphatic glandular system ; and 
then it commonly appears in the form of miliary tubercles, scattered through 
the adenoid tissue of the lungs. 

* 4 I would characterize all consumptive diseases heretofore classed under 
the terms Tuberculous and Scrofulous, together with the products of low 
and chronic inflammation, as instances of a lowered vitality of the bioplasm; 
and I would strongly insist on their being totally distinct, on the one hand, 
from cancer and other malignant diseases, the characteristic of which is a 
new kind of vitality, a new growth, perhaps parasitic, with new organic 
elements, foreign to those of the tissues which they invade and destroy ; 
and on the other hand, distinct also from total loss of vitality, death of the 
bioplasm, which would speedily result in decomposition, gangrene, and 
putrefaction ; to such a result phthinoplasms do occasionally lead, but it is 
not a part of their common history. That this latter distinction is not 
sufficiently observed by some German writers is evident from their applying 
the term necrobiosis to caseation, which, although a process of decay from 
lowered vitality, does not indicate the absolute death of every living part, 
as in a slough or gangrene. It will be seen in the chapter on Fatty De- 
generation (which thirty years ago was a special object of my study), that I 
have traced a resemblance to vegetable life in its process and products ; 
and, although ultimately destructive, it is the most gentle step towards the 
death of the tissues. Nay, various proofs will be adduced that fatty trans- 



H2 DYSPEPSIA. 



formation is often a salutary process, assisting materially in the removal of 
phthinoplasm and other superfluous products of inflammation.'' 

"The great indication to sustain the vitality and sufficiency of the bio- 
plasm, by all available means, medicmal, regiminal, and climatic, will be 
the first suggestion for the prevention and treatment of consumptive dis- 
eases. A second, equally obvious, will be the avoidance of all influences 
which may injure the bioplasm ; generally, by deleterious action on the 
whole body ; or locally, by exciting low inflammation in the lungs or other 
organs. A third indication, more difficult than the others in its fulfilment, 
is to counteract the injurious effects of phthinoplasms alread" formed, and 
to promote their quiescence or removal." 

DYSPEPSIA AND WORMS. 

All of the varieties of entozoa which infest the alimentary 
canal, would have no existence there, were it not for the pro- 
ducts of indigestion on which they feed. Because they are 
scavengers, some physicians, who were poor physiologists, have 
regarded them as wholesome and necessary to consume the 
offal, etc. But, in a healthy state of the digestive organs, there 
would be no offal for them to scavengerize. The effete matters 
(excretions) would be expelled as often as necessary, and not 
allowed to accumulate so as to afford shelter and sustenance 
for these troublesome pests. 

Children whose dietary consists largely of greasy foods, 
sugar, and fine flour, always have constipated bowels, and 
are always affected with worms. The immediate cause of all 
such vermin as effect a permanent lodgment in the alimentary 
canal is alimentary uncleanliness. And uncleanliness in our 
dwellings and surroundings is the sole cause of all the noxious 
insects or animalculae which annoy us and destroy our fruits and 
vegetables, as well as the cause of all contagious diseases — 
small-pox, measles, scarlatina, whooping-cough, mumps, 
influenza, etc., of human beings, and glanders, murrain, rin- 
derpert, epizooty, gapes, staggers, etc., of domestic animals. 

The "measly " livers of stall-fattened and sty-fattened cattle 
and hogs, is nothing more nor less than an insect, not unlike 
the louse or crab, which burrows in the substance of the liver, 
or lodges in some portion of the intestinal tube. Its form and 
shape conform to the locality in which it develops and propa- 



DYSPEPSIA AND THE CACHEXIES. 113 

gates its kind. In the bowels it elongates into the tape-worm. 
It often makes its way into other glands, and into the areolar 
and muscular tissues of animals, especially of the hog ; and is 
so tenacious of life that ordinary boiling does not destroy it. 
In the Crimea, during the late Turko-Russian war, the British 
soldiers became so frequently affected with tape-worms that 
they finally traced it to pork rations, and refused to partake of 
them. 

Raw sugars are another common source of "measles" in 
the glands and bowels. The sugar insect (which is the cause 
of that tormenting skin affection known as "grocer's itch), is 
found in nearly all of the brown sugars of commerce. More 
than one hundred thousand have been found in a single pound 
of "merchantable" Muscovado sugar. 

A late writer in an agricultural journal published at Memphis, 
Tenn., ("Philips' Southern Farmer") attributes worms in 
colts to indigestion. He says : " It is the opinion of many 
veterinarians that worms in colts are usually connected with 
indigestion ; that is, they produce ill-health when the digestive 
organs are disordered. ' They produce ill-health whenever 
present. Indigestion causes their presence, and then their 
presence aggravates the indigestion. 

A writer in a late number of the London Field states that the 
gape worm among chickens is unusually prevalent. If he will 
examine into the sanitary conditions around those wormy 
chickens, he will find uncleanhness correspondingly prevalent. 

We have the authority of Scripture that all "evil beasts shall 
cease out of the land" when the people obey "the ways of the 
Lord," which means, I suppose, when they keep themselves 
and their surroundings clean, and till the earth on hygienic 
principles. 



114 DYSPEPSIA. 



CHAPTER XIV. 
PRINCIPLES OE TREATMENT. 

There are two methods of treating dyspeptics ; one aims to 
cure the disease ; the other endeavors to cure the patient. 
All drug medical systems profess to cure diseases ; and they 
can do it, whatever becomes of the patient. The Hygienic 
medical system is based on the fundamental premise that 
disease should not be cured ; but that its causes should be remov- 
ed, to the end that the patient may recover health. All drug 
systems teach that disease is an entity or substance ; a some- 
thing at war with vitality which should be suppressed, opposed, 
counteracted, subdued, expelled, killed, or cured ; hence it is 
opposed with all of the missiles of the drug shop. The Hygi- 
enic system teaches that disease is a remedial effort — a struggle 
of the vital powers to purify the system and recover the normal 
state. This effort should be aided, directed and regulated, if 
need be, but never suppressed. And this can always be better 
accomplished without medicines than with them. 

Few persons are aware how many of their ailments, of which 
they suffer for years, if not for life, are attributable to the med- 
icines which so promptly relieved them of some trivial pain or 
slight indisposition. Many of the infirmities and diseases of 
youth and manhood can be traced to the remedies which cured 
their ailments of infancy and childhood. 

Professor E. R. Peaslee, M. D., of New York, said to his 
medical class a few years ago: "The administration of 
powerful medicines is the most fruitful cause of derangements 
of the digestion." 

Professor Alonzo Clark, M. D., of the New York College 
of Physicians and Surgeons, said, in a lecture to the medical 
class, not long since : "All of our curative agents are poisons, 
and, as a consequence, every dose diminishes the vitality of the 
patient " 



FOOD. 119 

cooked in any other manner that broiling or boiling ; and eggs 
should always be soft-boiled. 

Condiments and seasonings of all kinds can be disposed of 
in few words — the less the better. Those who are accustomed to 
high-seasonings will recover a more normal taste and soon learn 
to relish very plain cooking, by gradually reducing the quan- 
tity. I have known many persons learn to like all dishes bet- 
ter without sugar than with it in a few weeks, after having used 
it excessively for years. And I could make the same remark 
with regard to vinegar, salt and butter. None of these things 
are foods, in the proper sense of the word, the medical pro- 
fession to the contrary notwithstanding. 

Another important advantage of diminishing the thirst-pro- 
voking seasonings is, little or no desire for drink at meals. 

Much experience and observation have convinced me that 
the excessive use of sugar in this country is a prolific source of 
indigestion, constipation, "biliousness" and erysipelatous erup- 
tions. For fifteen years I allowed a part of my patients to use 
sugar moderately. For ten years past I have had no sugar on 
their table ; and the results of the change are, I hear but little 
of the heartburn, acidity, fetid breath, and "stomatitis" of 
which my patients formerly complained so much. 

At a meeting of the Polytechnic branch of the American 
Institute, at Cooper Union, New York, Professor J. V. C. 
Smith, M.D., in a lecture on milk, stated that the liver was a 
sugar-making organ ; and he argued that, because the liver 
performed a * ' glycogenic " function, children should be allow- 
ed to eat sugar freely — also adults. I do not see how the con- 
clusion is legitimate from the premises. If it is the business 
of the liver to make sugar, let the liver do it. The liver makes 
bile. Would Professor Smith recommend us to take bile as 
food? 



1 20 DYSPEPSIA. 



CHAPTER XVI. 

DRINK. 

Water-drinking between meals should be according to thirst. 
It is a mistake to load a weak stomach with cold water on the 
theory that it is a tonic. Food and drink have, fortunately, 
no medicinal properties, and should never be taken for any 
purpose but to supply necessary material for use. As a habit 
it is well to take a tumbler, or part of one, of pure soft water, 
after dressing in the morning, and let the drink be regulated 
by the thirst at all other times. As I have explained in the 
preceding part of this work, it is not compatible with perfect 
digestion to drink at all at meals. Those who use seasonings, 
and those who are thirsty while eating, should take as little as 
may be consistent with comfort. Small sips will often allay 
thirst as well as larger draughts and be much better for the 
stomach. Very cold water is certainly unhygienic at meals, 
and especially bad for dyspeptics. Some medical authors, and 
among them Dr. G. B. Wood ( " Wood's Practice of Medicine") 
recommend ice-cream after meals as a tonic. Few things could 
be worse. Hot coffee or tea would be the lesser evil. I have 
known many patients who were subject to inflammation and 
hemorrhage, suffer severely and invariably of bleeding piles 
soon after eating ice-cream, nor do I regard the iced-water, or 
bits of ice which are so generally administered to cholera pa- 
tients, as either proper or beneficial. The reason that they 
must be pernicious is sufficiently obvious to one who sees "the 
pathology of the disease" through unprejudiced spectacles. 
The cold water or ice in the stomach determines the blood from 
the surface of the body to the central organs, aggravating the 
internal congestion, which is the chief point and only danger 
in the case. So with dyspeptics whose internal viscera are al- 
ways in a greater or less degree of congestion, ice-cream or 
large draughts of cold water, not only interfere with the process 
of digestion, but determine the blood from the surface, where 



DRINK. 121 



it is already deficient, to the central organs where it is already 
in excess. 

The dyspeptic should avoid hard water as he would hard 
drugs, for all the hard waters on the earth are only drugs in 
solution. All of the mineral and medicinal springs, from 
Saratoga to White Sulphur, and from Cheltenham to Vichy, 
are only modifications of the oceans, the great reservoirs of all 
the impurities that water can dissolve. No one thinks of drink- 
ing them when well, nor would any one be content to have his 
food cooked in them. But when sick, presto, the more earthy, 
saline, alkaline, and mineral ingredients they contain, the 
more they are in demand ! Such is fashion. 

I have long been convinced that a better method for convert- 
ing grain into meal or flour than by grinding between stones, 
was among the desiderata of a hygienic mode of life. The 
ordinary process of grinding inevitably impregnates the meal or 
flour with more or less pulverized stone. The quantity may 
be infinitesimally small in a single loaf of bread, nevertheless 
some chance particle not reduced to impalpable powder may 
be transferred to the body of the one who partakes of the loaf, 
lodge in the joints, liver, kidney, or bladder, and become the 
nucleus of concretions which occasion painful or fatal diseases. 

The hygienic method of preparing meal (and flour should 
not be prepared at all) is by cutting or pounding, as was done 
before flouring mills were invented. And the following para- 
graph, which I copy from an exchange paper, indicates that the 
right idea has already become embodied in machinery : 

"Flour Without Millstones. — A machine for making flour without 
the use of millstones, has just been started in England. The grain is crushed 
by one thousand little trip hammers attached to the proper machinery to 
produce the results desired. The new machinery is very cheap and does up 
its work in a scientific manner. The flour produced is said to be far su- 
perior to that obtained by grinding. A pounding mill costing Si.cco will 
produce as much flour every day as an old fashioned mill, costing $5,000. 
The new mill is very simple. When a hammer is out of order you can re- 
place the same for a few cents. For four thousand years millers have pro- 
duced flour by grinding the grain with stones. The new idea gives a new 
departure. What results it will produce 11. this country remain to be seen.'* 



122 DYSPEPSIA. 



In those complications of indigestion indicated by torpid 
liver, gall-stones, intestinal concretions, albuminaria, or 
' Wright's disease of the kidneys," mineral and hard waters of 
all kinds are extremely pernicious. Anl they are scarcely less 
so in rheumatic and gouty affections, gravel, catarrh of the 
bladder or uterus, and duodenitis. 

There is no beverage in the universe except water, and there 
is but one rule for its quality — the purer the better. Those who 
reside where all the water of the streams, spring?, and wells is 
hard, have only the alternatives of getting their supply of fluids 
from juices, fruits and vegetables, catch rain water, obtain pure 
water by distillation, or be sick. Few persons imagine the 
" wear and tear " that is constantly disorganizing their structures, 
and bringing them prematurely to the grave, in consequence of 
drinking hard water. The foreign particles are everywhere 
occasioning a wasteful friction of the vital machinery, deranging 
the blood-corpuscles, damaging the secretions, and destroying 
the molecules of the tissues. If the railroad companies of the 
world, instead of keeping all the machinery of the locomotives 
and rolling stock well oiled, so as to obviate friction to the 
greatest possible extent, should apply sea-water, or Congress 
water, or the hard water of lime-stone regions, to the machinery, 
not one of the roads could pay running expenses ; the iron 
would rust, the wood work be strained, the joints would break, 
and all would go to ruin speedily. The principle that machi- 
nery will work long and well in inverse ratio to the friction, is 
as applicable to vital as it is to mechanical organisms. 



CHAPTER XVII. 
EXERCISE. 



Next in importance to a proper dietetical regimen, if not 
equally important, is systematic exercise. Those dyspeptics 
who are so fortunate as to have some healthful vocation, may 
need no special instruction on this subject, except in relation 
to special exercises for special morbid conditions. 



EXERCISE. 123 



One of these conditions, and probably the most prevalent 
one, and certainly the one most generally overlooked or un- 
thought of by medical men, is an inactive state of the abdomi- 
nal muscles. With all sedentary persons this is one of the 
essential matters to be attended to in the treatment. As has 
been already explained, no one can have a normal action of the 
bowels unless the muscles which constitute the walls of the ab- 
domen co-operate with the peristaltic action of the intestinal 
tube. Dyspeptics may exercise in vain, in a hundred ways, 
unless their muscles are brought into action and invigorated. 
And there is one method of exercising these torpid muscles 
which all dyspeptics can resort to with advantage without the 
aid of doctors or machinery, and which is one of the best 
"movement cures" ever invented. I mean, slapping the 
abdominal muscles with the flat hand. The slapping should 
be very gentle at first, so as to cause no pain, and gradually 
increased in force, as the muscles become active and elastic. 
Dyspeptics who are so tender over the liver or stomach that the 
weight of one's hand is painful, can in a few weeks or months, 
by persevering slapping, endure a blow that would do credit to 
a pugilist without inconvenience or injury. The exercise may 
be advantageously varied with rubbing and kneading ; and, 
after a while, when the tenderness is overcome, by pounding 
with the fist, the rule of beginning gently and gradually increas- 
ing the force being observed. The muscles of the loins and 
around the small of the back should also be exercised in the 
same way, which can easily be done with the back of the hand. 
This simple exercise alone has effected some "astonishing 
cures'' and is better for feeble invalids than all the appliances 
of a regular gymnasium. Very feeble dyspeptics should have 
these exercises passively, that is, made by an attendant 

Some forty years ago, a Mr. Halstead, of New York, effected 
some wonderful cures of feeble and emaciated dyspeptics, 
whose physicians had given them over to death, by a process 
of * ' kneading the bowels. " He afterwards invented an exer- 
cising chair to accomplish the same result. But the kneading, 



124 DYSPEPSIA. 



pounding, and slapping are much better than the chair, besides 
being more economical and always available. 

The following case, which occurred just forty years ago, 
illustrates the principle we are considering : Two of my 
schoolmates, eighteen and twenty-one years of age respectively, 
declined in health. The family physician called their ailment 
dyspepsia, and attended them one year. They grew no bet- 
ter. Then Thomsonian, root and Indian doctors, far and near, 
tried their steaming and compounds in vain. The young men 
continued to decline. Both were extremely emaciated and the 
younger was unable to sit up. The elder brother suffered ex- 
crutiatingly at times of colic, and, becoming convinced that he 
could not recover, in one of his unendurable paroxysms, com- 
mitted suicide by cutting his throat. A few days after this 
tragedy Mr. Halsted was heard of. A messenger was posted 
to New York, who paid a fee of $100; took a solemn oath 
not to disclose the secret, nor to apply it to any person but this 
individual patient, the younger brother. All medicine was 
discontinued ; the regimen was the same, and the manipula- 
tions were commenced. In a couple of weeks the skeleton- 
patient was able to sit up. In a couple of months he was 
walking about. In one year he was in the enjoyment of good 
health. He is at this writing a Christian minister. 

Another case of recent date is worth relating, as showing the 
benefit and the necessity for restoring the action of the abdom- 
inal muscles in desperate cases of dyspepsia. A merchant of 
Western New York visiting New York City on business, called 
on me for advice. He was one of the most miserable speci- 
mens of this miserable class of invalids that I ever saw — ema- 
ciated, the abdomen gaunt, and the muscles rigid, bowels 
torpid, and troubled with flatulence continually and colic 
frequently. All that he could eat without unendurable pain in 
the stomach was a small slice of stale bread and a bit of lean 
meat, and this meagre allowance usually occasioned so much 
gastric irritation that he had acquired the habit of taking a 
teaspoonful of brandy after each meal. He suffered constantly 
of hunger and could sleep very little. Like the majority of 



EXERCISE. 125 

such persons, he was in the pursuit of some nostrum or remedy 
that would impart to him health, while he continued to live and 
act in disobedience to all the conditions of health. He had 
destroyed his health in the eager pursuit of riches, and while 
intelligent in the ways and means by which property could be 
acquired, he was totally ignorant of nearly all the ways and 
means by which his own vital organs could be preserved. In 
ruining his health he had accumulated a hundred thousand 
dollars, and he made the remark, incidentally, that if he could 
recover his health at once he would be willing to give a thou- 
sand dollars ! 

I explained to him the nature of his malady, and called 
attention to his torpid and rigid abdominal muscles as the chief 
feature of his case. As my Hygeio-Therapeutic College was 
then in session, and as it happened to be one of the evenings 
for exercises, I invited him to the lecture hall. Some of the 
students were dancing the Schottische, and I explained to him 
how that method of "tripping the light fantastic toe" was 
admirably calculated to bring into action the torpid muscles of 
dyspeptics affected as he was. Other exercises might be equally 
useful, but this was one exactly adapted to his particular con- 
dition. He watched the terpsichorean performance with as 
much interest, probably, as he had often regarded the move- 
ments in fancy stocks. One year afterwards he called on me 
again. He was in fair health. He had learned the steps, and 
had danced the dyspepsia all away. 

Walking, horseback-riding, and rowing, are among the use- 
ful exercises for dyspeptics, but are no better than sawing wood, 
working in the garden, washing and ironing, only as they may 
be more amusing to the patient. But the rule here, as in danc- 
ing, or gymnastics of any kind, is to commence very mode- 
rately, and be regular and systematic. It is on account of their 
being more orderly and better systematized that the health-lift, 
dumb-bells, Indian clubs, and various calisthenic exercises are 
so frequently preferable. Many useful instructions in manual 
exercises of all kinds may be found in my work entitled, "The 
Illustrated Family Gymnasium." 



126 DYSPEPSIA. 

Invalids who undertake to regulate their own exercises al- 
most invariably overdo at first. Wishing to " hurry up the 
cure," they strain some part of the muscular system and actu- 
ally retard it "Make haste slowly," is the safe rule. Those 
who are subject to prolapsion of the lower portion of the bowel, 
or to bleeding piles, can scarcely be too moderate for a month 
or so in every new kind of exercise which they resort to. The 
reason is, that as the vigor and elasticity of some sets of mus- 
cles are much weaker than others, and the whole muscular sys- 
tem unbalanced, it takes time, practice, and much patience to 
get them all acting harmoniously. Some persons with weak 
digestive organs and enfeebled respiratory apparatus, have com- 
paratively strong limbs. They can walk miles without great 
fatigue of the muscles of locomotion ; while a smart run of 
thirty feet, or a quick step up a flight of stairs, makes the heart 
flutter and the breathing laborious. Such invalids need very 
little of the walking but much of various other exercises. They 
should practice going up and down stairs and over uneven 
surfaces frequently, always keeping the mouth shut, and never 
exercising with sufficient violence to feel the necessity of open- 
ing the mouth. And this practice should be persevered in until 
they can go up two flights of stairs on the " double-quick ,? 
without occasioning shortness of breath or palpitation. An 
excellent "movement-cure" process, and one available to every 
invalid who can walk, is to strike the abdominal muscles with 
the flat hand, and, after a little, with both hands, while walk- 
ing ; the blows to be exactly synchronous with the contact of 
the sole of the foot with the ground or floor, the glottis to be 
closed and the breath held at the moment the blow and step 
are made. This compound gymnastic exercise gives a remark- 
able spring to the muscles of the abdominal walls, as any one 
can ascertain by making the experiment properly. This move- 
ment can be practiced with still greater effect while walking up 
and down stairs. 

Those who have very weak lungs, or who are predisposed to 
consumption, should resort chiefly to such exercises as are 
especially calculated to inflate the lungs and expand the chest. 



BATHING. 127 



Whatever else they do or omit to do, there is no hope against 
final consumption except in keeping the lungs well filled with 
atmospheric air. Pulling against weights, tossing and catch- 
ing ball, light dumb-bells, wands, etc., are adapted to their 
purpose. One of the best exercises without the aid of artificial 
machinery is this : Stand erect, with the arms perpendicular ; 
. raise the hands slowly, keeping the arms extended till they meet 
palm to palm over the head ; then let them descend as slowly 
till they meet, palm to palm, behind the back, or in front, 
alternating these positions. The arms should go up-and-down 
to correspond with the respirations — fifteen to twenty per min- 
ute. Inhalation should take place as the arms ascend, and 
expiration as they descend. 



CHAPTER XVIII. 

BATHING. 

The majority of dyspeptics require very little "water-treat- 
ment." Before their cases come under the cognizance of the 
physician, their circulation is low and nerves enfeebled. In 
nine of every ten of these cases a proper dietary, or a judicious 
plan of exercise, is vastly more important than bathing, pro- 
vided any part of the remedial plan must be neglected. Yet 
bathing is in itself important, and in some cases will ensure 
success, when without it all other measures might fail. In the 
early days of ' ' Hydropathy, " packs, plunges, douches, and 
umschlags were overdone, on the false theory that disease was 
an entity, or a something at war with vitality, which must be 
expelled or cast out by a "crisis. " And even in these days of 
" Hygienic " institutions and Hygeian " Homes," wet-girdles, 
chest-wrappers, and head-caps are too much employed on the 
absurd notion of drawing out disease, or purifying the blood 
through an artificial depurating surface. "Do thyself no 
harm " is the first principle and the universal rule for managing 
the bathing part of the treatment. 



128 DYSPEPSIA. 



Not many years ago prolonged and very cold hip-baths — ■ 
one to two hours, temperature 50 degrees or below, were fre- 
quently prescribed as " tonic/' " derivative," or "sedative'' 
processes, on the erroneous supposition that water was in some 
sense a substitute for medicine. Such " heroic " management 
never failed to exhaust vital power and aggravate the malady, 
when it did not change it to some new form or worse compli- 
cation. 

Within a few years past, the invalid public, always running 
to extremes in everything, have been blundering just as absurdly 
the other way ; and very hot treatment — Turkish, Russian, 
etc., baths, have become the prevailing mania. They are 
more agreeable at first, but more debilitating in the end than 
were the extremely cold water processes. I have known many 
feeble dyspeptics killed by them, and several who were in the 
incipient stages of consumption hurried rapidly to their graves 
by them. 

The limits of this work will not permit me to explain in de- 
tail all the bathing processes, nor even mention all of their 
applications to all forms and conditions of ill-health, but I must 
refer those who desire fuller information on the subject to my 
small work, ' ' The Bath ; its Uses, " etc. 

It is impossible to give, in a work of this kind, anything more 
than a plan or set of rules to regulate the water-treatment, for 
the reason that the conditions of the patients are so different ; 
what is best for one may be worst for another ; one patient may 
be benefited by some form of bath once or twice a day, while 
another would be injured by any bath applied more frequently 
than once or twice a week. 

The following summary of such processes as can be man- 
aged in home-treatment, and such rules as all should observe, 
will serve as a chart or guide for the dyspeptic : 

Wet Sheet Packing. — On a bed, or matress, two or three comfortables 
or bedquilts are spread ; over them a pair of flannel blankets ; and, lastly, 
a wet sheet (rather coarse linen is best) wrung out lightly. The patient, 
undressed, lies down flat on the back, and is quickly enveloped in the sheet, 
blankets, and other bedding. The head must be well raised with pillows, 



BATHING. 129 

and care must be taken to have the feet well wrapped. If the feet do not 
warm with the rest of the body, a jug of hot water should be applied ; and 
if there is a tendency to headache, several folds of a cold, wet cloth, should 
be laid over the forehead. The usual time for remaining in the pack is 
from forty to sixty minutes. It may be followed by the plunge, half-bath, 
. rubbing wet -sheet, or towel-wash, according to circumstances. 

Half-Pack. — This is the same as the precedmg, with the exception that 
the neck and extremities are not covered by the wet sheet, which is applied 
merely to the trunk of the body, from the arm-pits to the hips. 

Half-Bath. — An oval or oblong tub is most convenient, though any 
vessel allowing a patient to sit down with the legs extended will answer. 
The water should cover the lower extremities and about half the abdomen. 
While in the bath the patient, if able, should rub the lower extremities while 
the attendant rubs the chest, back, and abdomen. 

Hip or Sitz Bath. — Any small-sized wash-tub will do for this, although 
tubs constructed with a straight back, and raised four or five inches from the 
floor, are much the most agreeable. The water should just cover the hips 
and the lower part of the abdomen. A blanket should be thrown over the 
patient, who will find it also useful to rub or knead the abdomen with the 
hand or fingers during the bath. 

Foot-Rath. — Any small vessel, as a pail, will answer. Usually the 
water should be about ankle deep. During the bath, the feet should be 
kept in gentle motion. Walking foot-baths are excellent in warm weather, 
where a cool stream can be found. The hot -and cold foot bath consists in 
holding the feet in water as warm as can well be borne — five, ten, or fifteen 
minutes — then dipping them a moment in cool or cold water, and wiping 
dry. 

Rubbing Wet-Sheet.— If the sheet is dripping wet, the patient stands 
in the tub ; if wrung so as not to drip, it may be used on a carpet, or in 
any place. The sheet is thrown around the body, which it envelops below 
the neck ; the attendant rubs the body over the sheet (not with it), the 
patient exercising himself at the same time by rubbing in front. 

Pail-Douche. — This means simply pouring water over the sheet and 
shoulders from a pail. 

Stream -Douche. — A stream of water may be applied to the part or 
parts affected, by pouring from a pitcher or other convenient vessel, held 
as high as possible ; or a barrel or keg may be elevated for the purpose, 
having a tub of any desired size. The power will be proportional to the 
amount of water in the reservoir. 

Towel or Sponge-Bath.— Rubbing the whole surface with a coarse, 



130 DYSPEPSIA. 



wet towel or sponge, followed by a dry sheet or towel, constitutes this pro- 
cess. 

The Wet Girdle. — Three or four yards of crash toweling make a good 
one. One-half of it is wet and applied around the abdomen, followed by 
the dry half to cover it. It should be wetted as often as it becomes dry. 

The Chest-Wrapper. — This is made of crash, to fit the trunk like an 
under-shirt, from the neck to the lower ribs ; it is applied as wet as possible 
without dripping, and covered by a similar dry wrapper, made of Canton or 
light woolen flannel. It requires renewing two or three times a day . 

The Sweating-Pack. — To produce perspiration the patient is packed in 
the flannel blanket or other bedding, as mentioned in the Wet-Sheet Pack, 
omitting the wet sheet. Some perspire in less than an hour ; others re- 
quire several hours. This is the severest of water-cure processes, ar 
in fact, is very seldom called for. 

The Plunge-Bath.— This is employed but little, except at the Esta- 
blishments. Those wlft have conveniences will often find it one o£ the best 
processes. Any tub or box holding water enough to allow the whole body 
to be immersed, with the limbs extended, answers the purpose. A very 
good plunge can be made of a large cask cut in two near the middle. It 
is a useful precaution to wet the head before taking a bath. . 

The Shower -Bath. — This needs no description. It is not frequently 
used in treatment, but is often very convenient. Those liable to a "rush 
of blood to the head," should not allow much of the shock of the stream 
upon the head. Feeble persons should never use this bath until prepared 
by other treatment. 

Fomentations. — These are employed for relaxing muscles, relieving 
spasms, griping, nervous headache, etc. Any cloths wet in hot water 
and applied as warm as can be borne, generally answer the purpose ; but 
flannel cloths dipped in hot water, and wrung nearly dry in another cloth or 
handkerchief, so as to steam the part moderately, are the most efficient 
sedatives. 

Injections. — These are warm or tepid, cool or cold. The former are 
used to quiet pain and produce free discharge ; the latter to check excessive 
evacuations and strengthen the bowels. For the former purpose ~ large 
quantity should be used ; and for the latter a small quantity. 

General Bathing Rules. — Never bathe soon after eating. The most 
powerful baths should be taken when the stomach is most empty. No full 
bath should be taken less than three hours after a full meal. Great heat 
or profuse perspiration are no objections to going into cold water, provided 
the respiration is not disturbed, and the patient is not greatly fatigued or 



BATHING. 131 

exhausted. The body should always be comfortably warm at the time of 
taking any cold bath. Exercise, friction, dry wrapping, or fire may be re- 
sorted to, according to circumstances. Very feeble persons should com- 
mence treatment with warm or tepid water, gradually lowering the tempe- 
rature. 

The temperature of baths should always be regulated by the 
temperature of the patient. Very feeble invalids should never 
take very hot nor very cold baths of the whole surface, although 
hot or cold Applications may be made locally to relieve spasms 
or check discharges. Dyspeptics who are not emaciated and 
are not disposed to chilliness may take a tepid ablution — 70 to 
80 degrees — each morning, and a hip bath each afternoon for 
ten minutes, at 75 to 85 degrees. For feebler persons the tepid 
ablution or wet rubbing sheet each other day is sufficient, with 
the hip-bath on the alternate day. Still feebler persons may 
take the tepid rubbing sheet one day, the dry rubbing sheet the 
second day, and the hip-bath the third day, and so on ; and if 
extremely feeble the wet rubbing sheet should only be employ- 
ed once a week, and the dry rubbing sheet on the other days. 
The dry rubbing sheet is practically an air-bath, and has never 
been sufficiently appreciated in or out of health institutions. 

Sun-baths are among the best appliances in self-treatment, 
as most patients can manage them without assistance. All 
that is needed is a sunshiny place, in-doors or out, where the 
temperature is agreeable. The patient has only to expose the 
naked body to the sunlight and make gentle friction over the 
whole surface with dry towels, or a sheet, for five to ten min- 
utes. 

For bathing purposes, as for drinking and cooking, there is 
a great difference between pure and hard water. Hard and 
impure water may be better than none, but the rule is, the 
purer the better. 



132 DYSPEPSIA. 



CHAPTER XIX. 
CLOTHING. 

So far as the recovery of health is concerned, the dyspeptic 
has only to dress in the most comfortable manner possible to 
insure the best possible results. But fashion has so demoral- 
ized judgment, perverted taste, and enslaved the minds of our 
people that it seems necessary to say a good deal on this sub- 
ject, in addition to what has been said and illustrated in the 
first part of this work ; and as the young ladies all over our 
country are going to ruin in droves because of the unwhole- 
some garments that they put on, a few more "lines upon lines 
and precepts upon precepts, "' may not be inappropriate. 

We should always keep in mind that clothing can never 
impart heat to the body ; it only retains the heat which the 
body imparts, which heat of the body is owing to the circulation. 
The better the conducting material of clothing the more readily 
the heat of the body passes through it ; and the more non- 
conducting the material the longer the heat is retained ; hence 
in warm weather, linen and cotton, and in cold weather woolen 
and fir, are best adapted to maintaining an equilibrium of 
bodily temperature. 

Says a writer in the Science of Health : 

" We can easily understand how a delicate woman, weighed down by a 
mass of heavy clothing that would fatigue a strong man, with all her phys- 
ical powers depressed and her circulation reduced to a low ebb, should 
shiver with cold, within the most abundant wrappings. Do not make the 
mistake of supposing that a heavy fabric is necessarily a warm one. It is a 
fact that a few folds of light fleecy material thrown loosely together are 
a much more eHicient protection against cold than a double thickness, even, 
of some stuff four times its weight, and as compact as a board. Let wool 
and fur, both in their natural shape bad conductors of heat and therefore 
well calculated to preserve the natural warmth of the body, enter largely 
into the attire, and m as light a form as possible ; refuse positively to don a 
garment of any sort in any weather, whose shape and weight shall impede 
the movements or cause the least sensation of fatigue in wearing it, and above 
all avoid weighing down the hips with the multiplicity of skirts which are 



CLOTHING. 133 



the abomination of the present age of dress ; give the shoulders their proper 
share of the weight of the clothing to sustain ; allow no uncomfortable 
restrictions to impede the free action of the organs of breathing and circu- 
lation, and you may bid farewell to pains in the back and shoulders, to 
headache, and to difficulty of breathing ; you will ride less and walk more, 
for walking will then be a pleasure, instead of an almost impossible task, 
as it is to a fashionably -dressed woman now-a-days." 

The Washington Star newspaper makes the following re- 
port of a lecture recently delivered in the Congregational 
Church of that city, by Mrs. Chandler. It is certainly 
"plain talk," but as it is talk that every person ought to 
hear, and this book is intended for everybody to read, it 
may be properly recorded in this place : 

" Our denaturalized, deformed, depraved tastes render us an easy prey 
to the tricks of the tradesmen on both sides of the water. Suppose our 
dwellings to be constructed upon a model planned acrossthe ocean, with- 
out reference to our climate, our American modes of living, our physical de- 
mands, our means, our health or our comfort. Yet that is the stupid 
way in which we are led in that which comes nearer to us than our 
houses— the dress we wear. 

"Our grandmothers have injured this whole generation with their broad- 
board corset, and we, already diseased from many other causes beside, 
and lacking their plumpness and beauty, are completing the wreck by 
binding and pinching and pressing and padding until the woman who re- 
tires at night is so unlike the one who walked by day that we need not 
wonder that the bridegroom, frightened by the dissolving view, does not 
know which is the bride, the clothes or the woman. 

44 The dress of the Friends is simple enough, but proves to be neither eco- 
nomical nor convenient. The Primitive Methodist dress, designed to be 
repulsive, died away for lack of beauty. When man was recognized as 
creator of the child, master of the woman, and disposer of the daughter, 
he arrayed himself accordingly in gorgeous apparel ; but with the partial 
elevation of woman his pride has taken a new departure, and the average 
American man now takes pride in the dress of his wife. While he consults 
freedom, ease, convenience and health in his own dress, he is glad to know 
that his wife and daughters represent his resources in their wardrobe. 

" Emily Faithfull says the larger number of those who come to her in ex* 
treme destitution for assistance to obtain employment are widows and daugh- 
ters of clergymen and other men of moderate income who have been ac- 
customed to being supported, and had never learned any means whatever 
of earning, accumulating, investing or saving. Philanthropic women in 
our own country give the same testimony. It is but a step from helpless 



134 DYSPEPSIA. 



destitution to hopeless degradation. Women in this Republic have esta- 
blished a caste in dress which makes a young woman whose father has an 
income of $1,500 feel that she must compete with the young lady whose 
father has $15,000 per annum, and the girl who earns $5 a week must in 
all respects keep pace with the one who receives $15 a week. 

" The demands of fashion are more imperative than the demands of virtue, 
and a young lady feels more disgraced by an unfashionable garment than 
by soiled under clothing or dilapidated morals. Grinder & Co., willing to 
swell the list of lost sheep, offer a young lady $3 a week for constant labor, 
and when she states that it is impossible to even purchase food and shelter for 
that sum, they politely inquire if she has not some gentleman friend who 
will make up the balance ; or, still more blandly, * We will give you $20 a 
week, and you need not work at all.' " 

We need only remark, in concluding this chapter, that 
tight shoes or boots are two evils that should be avoided by 
all who would keep well, and especially by all dyspeptics 
who would regain health. Tight-fitting shoes or boots con- 
duce to coldness of the feet, a symptom that always troubles 
feeble invalids in cold weather ; while high heels throw the 
whole body out of perpendicularity, and render all exercises, 
more especially walking, net only less pleasant and less bene- 
ficial, but in some instances positively injurious. Let a feeble 
person, accustomed to walk one mile a day over heels one 
inch thick, reduce the thickness to one-third of an inch, and 
he may experience at once the difference between laborious 
toil, and agreeable and useful recreation 

Nothing can be said in favor of the il stove-pipe" hat which 
has so long oppressed the heads of men ; it is conducive to con- 
gestion of the brain in some degree, baldness, and in persons 
predisposed to apoplexy actually dangerous. Whatever is 
worn on the head should be light and soft, or "softening of 
the brain " may be the final result. 

In behalf of dyspeptiG clergymen I must protest against the 
unhygienic manner in which fashion has dressed their necks : 
and as an article in the Christian Advocate expresses the right 
sentiments, I quote : 

Ministers' Cravats. 
" Who but Satan could ever have invented a * minister's choker?' The 
idea of tying a band, a cravat, or anything else closely about the throat, 



CLOTHING. 135 



thus paralyzing all the organs of the voice, is absurd and cruel in the ex- 
treme. Let the neck be free ; and let all the bands around it be from one 
to two inches larger than the neck itself. If a collar-band is close, 
unbutton it. The neck will expand nearly an inch when the veins are sur- 
charged with blood during the active mental and bodily exercise of public 
speaking. Then a loose collar becomes close, and the swollen veins, press- 
ing against the cravat, are unable to bring back to the heart the blood 
which the arteries have conveyed to the head. The arteries keep pouring 
their flood into the head ; the veins swell, and cannot return it ; the blood 
dams up, a dark and livid flood ; the face looks red and purple ; thought 
ceases, ideas vanish, words fail, and the preacher is confused, stammers, 
and 'breaks down.' 

"'Result of extempore preaching,* says one; 'Embarrassment,' says 
another; 'better stick to the manuscript.' Fudge! it is simply a close 
cravat — such a rigging would choke an apostle, and no man can preach 
when he is choked. 

" The throat is a wonderful instrument of music. Place the fingers upon 
it, and every time you speak you can feel the vibration of the vocal organs, 
producing sound. Anything that even touches the throat impairs the 
purity of these sounds. Fling a cloth over the strings of a piano or violin, 
and get music out of it if you can. So every cloth which surrounds the 
throat impairs the sweetness of the voice. Women go with necks bare — 
men have theirs swathed and bandaged, and ten women have sweet voices 
where one man has one. A man's voice should be as pure as a woman's. 
Why is it not ? He is shaved and choked. 

" God has provided a covering for man's throat — light and soft, it clothes 
the neck and preserves the health ; but a man gets a sharp iron, scrapes his 
neck, ties a rag around it, takes cold, has sore throat, bronchitis, and con- 
sumption, and dies. 

" Preacher of the Gospel, strike for freedom and for life. Fling away 
the razor. Tarry in Jericho till your beard has grown. Throw off then, 
gradually, but entirely, the bandages about the neck ; stand erect, breathe 
freely, think, speak, and act, in blissful exemption from embarrassment, 
and exemplify what a man can be who fears God and cuts loose from the 
fashions of a fleeting world." 

The sanitary view of the color of clothing is correctly stated 
by Dr. Nichols in the Journal of Chemistry : 

"The color of clothing is by no means a matter of indifference. White 
and light -colored clothes reflect the heat, while black and dark-colored 
ones absorb it. White is the comfortable and fashionable color for clothing 
in summer. It reflects heat well, and prevents the sun's rays from passing 
through and heating the body. If white is the best color for summer, it 
does not follow that black is the best for winter. It must be remembered 



136 DYSPEPSIA. 



that black radiates heat with great rapidity. Give a coat of white paint to 
a black steam radiator, which is capable of rendering a room comfortably- 
warm at all times, and the temperature will fall at once, though the heat- 
producing agency remain the same as before. A black garment robs the 
body of a larger amount of heat than white, and consequently the latter 
color is the best for winter garments. It is the best color for both summer 
and winter. Although this statement may seem like blowing hot and cold, 
it is nevertheless true. Let those who are troubled with cold feet, and who 
wear dark socks, change to white, and see if the difficulty is not in part or 
wholly removed." 



CHAPTER XX. 
SLEEP. 



I have never known a dyspeptic invalid who could sleep too 
much ; but I have known many whose chief burden of com- 
plaining was sleeplessness. The rule for them all is, sleep as 
much as possible. But there is a difference between dosing, 
dreaming, or lying in bed, and sleeping. 

It is a physiological law that assimilation mainly takes place 
during sleep. When the mental powers are in repose, the food 
elements, which have been elaborated by the digestive processes 
during the day, are formed into tissues and structures. The 
rapid emaciation of the body, and the delirium or insanity 
which affects the brain, in all cases of protracted wakefulness, 
prove that no one can be deprived of normal sleep without 
absolute deterioration of health and certain abbreviation of 
life. And it is a fact that ought never to be lost sight of in 
managing irritable and restless dyspeptics, that the nervous tem- 
perament and brain-labor necessitate a greater amount of 
sleep, than do the vital, or motive temperament and manual 
occupations. 

Sound sleepers are generally sound thinkers, for the reason that 
the wear and tear of brain substance is well renovated. They 
are also powerful workers and long-lived, for the reason tha 
the waste of the vital organs is well repaired. And it may be 
stated as an invariable law of life, that no one ever did or evei 



SLEEP. 137 

can be deprived of normal sleep without detracting correspond- 
ingly from vigor of both mind and body, and length of days. 

Much is said in these days of fast living, commercial energy, 
and the mad pursuit of immediate pleasures and sensuous 
indulgences, of overworked brains, as a cause of dyspepsia. 
The true cause is, abused bodies. The brain cannot be over- 
worked, provided the vital conditions are properly attended to. 

A few years ago Dr. Edward Johnson, of London, wrote a 
book in which he maintained the paradoxical positions that 
" dyspepsia is not a disease of the stomach ; constipation is not 
a disease of the bowels \" The statements are simply absurd ; 
but they have some degree of plausibility as explained. Dr. 
Johnson argued, that as mental worryment, a feverish anxiety 
to get rich, too close attention to business matters, "and ' ' over- 
worked brains, " were among the chief producing causes of dys- 
pepsia, the real disease was in the brain instead of the digestive 
organs. But this is confounding causes and consequences. 
Dyspepsia, as the term implies, affects primarily and principally 
the digestive organs, be the causes what and where they may. 

I am of the opinion that, taking all the people of this coun- 
try, or of the whole earth, ten persons underwork their brains 
to every one who overworks them ; and that ten persons over- 
work their digestive organs to every one who underworks them. 
Brain-work is in itself as healthful as any vocation can possibly 
be ; indeed, a certain and a considerable amount of it is essen- 
tial to the best condition and highest vigor of the vital organism. 

Dr. Beard, in a late article in the Independent, makes the 
following judicious observations : 

"Persistent sleeplessness is a symptom that should always bring home to 
us the query whether we are not in some way overworked or overworried. 
Inability to sleep is one of the most constant precursors and accompani- 
ments of cerebral exhaustion and decline. I have been informed by excel- 
lent and direct authority that Mr. Greeley stated during the last campaign 
that for fifteen years he had not had a good sound sleep. To those of us 
who have been accustomed to see him dozing on the horse-cars, in the 
omnibuses, and at church, this statement seems quite surprising ; but it is 
probable that by these extemporaneous naps he sought to make up for the 
wakeful hours of the night. 



138 DYSPEPSIA. 



" Sleeplessness is oftentimes the prayer of the cerebral lobes for relief from 
work and worry, and it should never go long unanswered. Some of the 
greatest and healthiest natures of the world— like Goethe and Thorwaldsen — 
have had a "talent far sleeping," which made all their other talents 
shine at their best, for the brain is never so brilliant as just after fully 
awaking from sound repose. Sir Walter Scott found by experience that 
his mind was clearest for thinking out his novels just after rising, and for 
that reason he took pains to prolong as much as possible his morning toi- 
let ; and in the same way we may explain the fact that Calvin loved to com- 
pose while lying in bed. 

" In great and pressing cnses, when our work and our causes for worry 
are trebled, the temptation is very strong to cut short our hours of sleep ; 
but these are just the occasions when, if possible, we should sleep the most. 
General Grant is credited with the statement that he owed the preservation 
of his health during the late war to the fact that, come what might, he 
always would have Irs eight or nine hours sleep. At one time, during the 
Vicksburg campaign, I believe, he was unable to obtain this, and then he 
began to suffer. Gladstone has declared that when he enters his home he 
leaves the cares of state behind him. 

" Sleep is food for the brain. If a penny saved is a penny earned, then to 
economize nerve force by rest is, within certain limits, to supply nerve force 
by eating and drinking. 

" To work hard without overworking, to work without worrying, to do 
just enough without doing too much — these are the great problems of the 
future. Our earlier Franklin taught us to combine industry with economy ; 
our ' later Franklin ' taught us to combine industry with temperance ; our 
future Franklin— if one should arise — must teach us how to combine indus- 
try with the art of taking it easy." 

Some dyspeptics will sleep best the fore part of the night, 
and others the latter part, or early in the morning. Such pa- 
tients should practice * i early to bed and not early to rise, ' 
until the habit of regular and orderly sleeping is acquired. I 
hardly need say that such persons especially, as well as all 
other persons generally, should avoid late or heavy suppers, and 
all exciting exercises, occupations, or thoughts after sunset. 

Sleepless dyspeptics are very liable to cold feet, and some- 
times despite any quantity of bedding. In such cases bottles 
of hot water, bags of hot sand, or hot bricks should be placed 
at the feet. If a couple of bricks are well heated, and wrapped 
in two or three folds of woolen cloth, they will remain warm 
ten or twelve hours. 



VENTILATION. 1 39 



CHAPTER XXL 
VENTILATION. 

In the Chapter on Aeration, in the first part of this work, 
we have seen the relation of respiration to nutrition. The 
food elements can never be properly elaborated without free 
and unimpeded breathing ; nor can they be well fitted for 
assimilation unless the air be pure. The impurities in the air 
we breathe, like those in the water we drink, or in the food we 
eat, not only poison the blood and obstruct the organs with 
foreign matters, but prevent the proper aeration of pabulum 
in the lungs. In both of these ways does impure air tend to 
derange the digestive organs. 

But another very common, I had almost said universal 
source of blood contamination, is the re-inhalation of carbonic 
acid gas which has been exhaled, and the inhalation of the 
waste matters of the body consequent on ill-ventilated apart- 
ments. It is because no provision is made for ventilation that 
so many tenement houses of our cities are so pestilential, ever 
breeding typhoid fevers and other zymotic diseases. Our com- 
mon school-houses, not being quite so bad, because only 
occupied during a part of the day, do not infect their inmates 
with sufficient rapidity to engender acute diseases, but are foul 
enough to cause a variety of chronic affections, and predispose 
to dyspepsia and many of its complications, especially those 
which are termed scrofulous, or tuberculous, bilious, scorbutic, 
etc. At this writing the Health Department of New York City 
are inspecting school-houses, factories, and public buildings, 
with the view of ascertaining their sanitary conditions. Dr. E. 
H. James, City Sanitary Inspector, made a report to the Board 
of Health, a few days ago, from which I make the following 
extract, which is equally applicable, doubtless, to many cities 
besides the commercial emporium, and, I fear to many rural 
districts : 

" In connection with the recent inspections of public school buildings 
and factories, made by the Health Inspectors, I directed, on the 3d inst., Dr. 



140 DYSPEPSIA. 



II. Endemann, Assistant Chemist of the Department, to collect specimens 
of air from a few of the schools and other public buildings, and submit them 
to chemical analysis, for the purpose of determining the amount of carbonic 
acid and other impurities. This duty he has performed, and I herewith 
present a brief abstract of his report. 

" The following places were visited for this purpose : E. C. Higgins' 
carpet factory, foot of West Forty-third-street ; Farren & Guetal's felt 
factory, No. 319 East Twenty-second-slreet ; Johnson & Falckner's hair % 
cloth factory, Nos. 246 and 248 Sixth Avenue ; Mellen & Co.'s horse hair, 
No. 518 East Seventeenth-street; Tombs Prison; Elm-street School; 
Roosevelt -street School; Thirteenth-street School, near Seventh Avenue ; 
Thirteenth-street School, near Sixth-avenue ; school, Nos. 97 and 99 
Greenwich-street ; school in Vandewater-street ; school in Madison street, 
near Jackson. Specimens of air obtained from two of the factories men- 
tioned were examined and found to contain from 14.7 to 16.7 partsof car- 
bonic acid in 10,000 parts of air, averaging about four times the normal 
quantity, which is 4 parts in 10,000. 

The mechanical impurities generally consisted of the dust arising from the 
operations pursued, and were either of an organic or inorganic nature. Of 
the former, fine sharp pieces of hair, by irritating the mucous membrane of 
the respiratory organs, form the most frequent source of bronchial or 
pulmonary affections among this class of operatives. 

'* The air in the male department of the Tombs Prison was found to con- 
tain 14 7 parts of carbonic acid in 10,000 as an average of two experiments, 
and that in the female department 8.45 parts, being also the average -of 
two experiments. 

" From our public schools Dr. Endemann obtained seventeen samples of 
air the examination of which determined the presence of carbonic acid> 
varying in amount from 9.7 to 35.7 parts in 10,000 or, in other words, 
from more than twice to nearly nine times the normal quantity. The ven- 
tilation in these buildings is generally faulty and can be obtained only by 
opening the windows, a practice detrimental to the health of the children 
who sit near or directly under them. The following experiments, made in 
the Roosevelt -street School, shows the inefficiency of ventilating flues 
in the wall unprovided with means for creating an upward current. An 
examination of the air in one of the class-rooms provided with a ventilating 
flue, was made while one of the windows was open, and yielded 17.2 parts 
of carbonic acid in 10,000. The window was then closed, and after the 
lapse of ten minutes another examination gave 32.2 parts of carbonic acid, 
or an increase of 15.6 parts. The experiment now became to the teacher 
and children so oppressive that it was not continued. Dr. Endemann 
says: ' If the accumulation of carbonic acid had been allowed to continue 
we might have reached within one hour the abominable figure of no.' 



VENTILATION. Ml 

The following is a statement of the average result obtained from the 
several experiments made in each school. 

Carbonic Acid. 

Elm-street School, three experiments 14.6 

Roosevelt-street School, two experiments 19.5 

Thirteenth-street (near Sixth-avenue) School, two experiments 28.1 

Greenwich-street School, two experiments 17.6 

Vandewater-street School, two experiments 14.7 

Madison-street School, four experiments 24.2 

As expired air contains not only this poisonous gas, but also effete animal'*- 
matter escaping from the bodies of those present, and in quantities in 
proportion to the amount of carbonic acid exhaled, and it follows that air 
vitiated by respiration is far more deleterious than air vitiated by the same 
amount of carbonic acid from other sources, and as the standard of per- 
missable impurity has been placed by high sanitary authority (Dr. Parkes 
and others ) at six parts of carbonic acid in 10,000 of air, it is evident that 
the best practical talent should be engaged in designing and perfecting 
means for securing to our public schools adequate and thorough ventilation." 

I recommend the Sanitary Inspector to test the atmosphere 
of some of our first class hotels. He will find it quite as car- 
bonic as in some of the school-houses, besides being redolent 
of a worse miasm, and a more efficient cause of dyspepsia and 
consumption — tobacco smoke. 

The most prevalent error in private houses is insufficient 
ventilation of the bed rooms. Many persons who take great 
pains to have pure air and plenty of it during the day, will take 
as much pains to exclude it during the night. Many a dys- 
peptic is fidgety, nervous, and sleepless half of the night, and 
irritable and melancholy all the next day, simply because he 
had been told by somebody that "night air is dangerous,'* 
and had excluded it from his room as much as possible. Such 
persons ought to be informed that out- door air is always better 
and never worse than in-door air. 

Young children and infants, though born with fair organiza- 
tions, are often rendered puny and scrofulous by sleeping in 
unventilated rooms. 

Notwithstanding the many " physiologies for schools, " the 
scores of medical journals, the lectures and writings of health- 
reformers, and the wide distribution of health periodicals, the 
ignorance and recklessness of the great majority of the people 



142 DYSPEPSIA. 



on the relation of respiration to health is astonishing. Any 
one may have a demonstration of this fact any cold or cool day 
between New York and Philadelphia, during the stove season. 
A few days ago I was on a train between these places. The 
day was warm and sunny ; there was a little snow on the 
ground, which was rapidly melting. In the car were two stoves 
nearly red-hot; nearly every seat was occupied, not one window 
was raised, and every little ventilator overhead was closed tight. 
The air soon become so foul that I was actually nauseated, and 
several of the passengers were nearly asphyxiated — as their 
semi-sleepy appearance and stupid dozing but too plainly in- 
dicated. Unable to get a seat by the window, I occupied my- 
self in passing from one car to another, "standing on the 
platform" with a decided disposit'on-to trespass on the "rules 
and regulations " every time I changed cars, In this manner 
I managed to ventilate myself until a seat next a window was 
vacated, when I raised the window and ventilated the whole 
car. Y T et in this car were full-grown men and women, well- 
dressed, some of them ornamented with jewelry and diamonds, 
and all of them appearing intelligent in the ways of business 
and fashion. Whose fault was it that they had never been 
taught that atmospheric air is "the breath of life " ? 



CHAPTER XXII. 

LIGHT. 

Bright light and sunshine are among the remedial in- 
fluences not to be disregarded in the management of dyspep- 
tic invalids. The congestion of the large internal viscera, the 
liver especially, disposes them to melancholy and gloominess, 
which condition and feelings are always aggravated by dark and 
shaded apartments. There is, moreover, an innervating and 
inspiriting influence in sunlight; hence dyspeptics should 
spend as much time as possible out of doors in clear weather, 
only avoiding the direct rays of the sun when they are painfully 
hot. Window curtains should be eschewed, even though the 



LIGHT. 143 

sunlight fades the carpet ; nor should dyspeptics sit in parlors 
where the light is excluded, however luxuriously furnished. 
Light will do more for the vitiated blood, morbid secretions, 
and neuralgic nerves than glittering mirrors and downy sofas. 

It is well known to physicians that the people who reside on 
the sunny side of the streets of our cities are less liable to scrof- 
ula, zymotic diseases, and cholera ; and that underground 
apartments, where direct sunlight never enters, are prolific 
sources of tubercular affections in all their multitudinous forms. 
•Those whose hard fortune compels them to occupy such places 
are almost always affected with measly and enlarged livers, and 
generally also with tuberculosis of the mesenteric glands, fre- 
quently extending to the liver and lungs. 

Children should be allowed to expose their heads and faces 
(and the whole surface frequently) freely to sunshine ; if 
freckles mar the beauty of the girl, it will be amply com- 
pensated by the fresher complexion and superior beauty of the 
woman. Parasols, except in the middle of the day during the 
"heated term," are pernicious things, as are the veils with 
which so many fashionable or fashion-aping ladies, shade their 
faces. They invariably render the eyes weak and irritable, 
aggravate congestion of the brain, and predispose to headache 
and innumerable indispositions which come under the compre- 
hensive phrase, ' ' nervousness. " 

There is much food for reflection in the following paragraph, 
which I copy from the Philadelphia Evening Star ; 

" The Sun a Physician.— Which is to be preferred, a faded carpet or a 
faded complexion ? Nine tenths of our lady friends will say a " faded car- 
pet," and yet how few of them give a practical expression to their preference. 
If some of the pale-faced women, so many of whom are seen daily in the 
street, could be prevailed upon to make up their minds to let the sunlight of 
heaven visit them more frequently and more liberally m their dwellings, they 
would soon find that the bright, rosy colors abstracted from the carpets would 
be transferred to their cheeks again, and, more than this, that the lassitude 
and weariness of which they complain would be replaced by the freshness 
and vigor of robust health. 

"No greater mistake can be made than that of excluding the sun from 
the dwelling. The sun is a great physician. Its curative powers are not 
sufficiently understood. If the benefits of a sun bath daily, of sun in the 



144 DYSPEPSIA. 



parlor, the sitting-room and the bed-chamber were as extensively advertised 
as are some of the quack nostrums of the day, and as generally patronized, 
how many more bright eyes and rosy cheeks we should see, and how many 
less pale-faced invalids. Give Dr. Sun a fair trial. 



CHAPTER XXIII. 

TEMPERATURE. 

Our climate, though marked temperate on the maps, is very 
intemperate in its vicissitudes, the thermometer ranging more 
than ioo degrees, and, in some years, 120 degrees Fahr. In 
summer hundreds die of " sunstroke," and in winter as many 
die of extreme cold. But this mortality is much more attrib- 
utable to invalidism, or to unhygienic habits or to other cir- 
cumstances, than to alternations of temperature. Good health 
can be enjoyed whenever good digestion can be performed. 
It is true that man can only attain his highest development 
within certain isothermal lines ; for the relaxing heat of the 
tropics renders him indolent, while the extreme cold regions 
make it impossible for him to do much more than provide 
necessary food and shelter. There is, however, no necessity 
for dyspeptic invalids to go away from any non-malarious part 
of the United States in order to recover health, provided they 
make the proper use of such hygienic measures as are obtain- 
able in all healthful localities. Eastern consumptives have a 
fashion of going to Minnesota; but as they generally depend 
on the climate there to effect the cure, and disregard nearly 
all other conditions of health, they seldom recover, except from 
the incipient stages of their ailment. And northern dyspeptics 
have a fashion of spending their winters in Florida, the 
Bermudas, or some other place where milder skies prevail in 
the winter season. They may enjoy themselves better in these 
places, during the cold months, than they could at home, as 
they "live, move, and have their being/' more in the open 
air, and may prolong life ; but they seldom recover. Dys- 
peptic, like consumptive invalids, generally carry all their bad 



TEMPERATURE. 145 



habits with them, trusting to the " one-ideaism " of dimatopa- 
thy ; but as they cannot travel away from themselves, if they 
cany their maladies and the causes of them wherever they go, 
changes of place, as a general rule, only make a miserable 
life more tolerable, and perhaps more protracted. Proper 
clothing, suitable dwellings or apartments, and hygienic hab- 
its, render it possible for all curable dyspeptics to recover 
health in almost any latitude or locality where it is fit for a 
civilized human being to have his " local habitation and his 
name. " 

A writer in the 'Atlantic Monthly for March, 1873 (George 
A. Shone), proposes a plan for superceding Florida and the 
Antilles, more magnificent and praiseworthy than useful or 
practical. His "institution " contemplates a forty-acre crystal 
palace, so arranged with steam-heaters and ice-reservoirs that 
the temperature could be regular to any degree desired ; walks, 
fountains, statuary, flowers, shrubbery, etc., are to make the in- 
side attractive, while boulevards, parks, play-grounds, gardens, 
drives, and hotels are to surround the immense structure of 
glass and iron. The cost is estimated at some twelve millions 
of dollars, and the income — two dollars a day for board — at 
nearly one million. The financial basis is well arranged, but 
who would be benefited by it ? 

It would be patronized mainly by the idlers who would go 
there to "kill time," and the pleasure seekers, who are forever 
in the pursuit of new sensations under difficulties ; and there 
are quite too many attractive places of resort for such persons 
already. 

If Mr. Shone supposes that dyspeptics could be happy in 
such an Eden, it is because he has not had many of them to 
manage. A majority of them would find the ideal paradise a 
real purgatory. The contrast between so many things to enjoy 
and their never-absent but ever-changing aches and pains, 
would aggravate their wretchedness, transform hypochondria 
to madness, and doubt to despondency. A plain cottage, a 
rough road, a sylvan grove, a natural river or stream, and 
society among farmers or mechanics who pursue some useful 



146 DYSPEPSIA. 



vocation, and whose habits, dress, style and associations are 
more in accordance with the order and simplicity of nature, is 
what they need. When some intelligent philanthropist will 
arrange a forty-thousand-acre farm into gardens, and orchards, 
and workshops, construct plain and convenient dwellings, and 
provide work where invalids can pay their way, as well as play 
grounds for recreation, he will do one of the things needful. 
It is the poor producers, not the rich consumers, who should be 
the study of the world's charity and benevolence. 



CHAPTER XXIV. 
MENTAL INFLUENCES. 

Pleasant scenery and cheerful companions are certainly 
among the desiderata for dyspeptics. They must have exercise, 
and whether work or play is best, when only one is available, 
depends on which is most enjoyable ; for exercise, like food, 
does most good when it is best relished. In a perfect system 
of exercise for invalids, a variety of work, and different plays, 
would be embraced in the remedial programme. All work 
and no amusement begets stupidity and adds to melancholy; 
while all play and no useful work degenerates into selfishness 
and dissipation. The wise man and skilful physician will com- 
bine the two in such manner as to suit the various conditions 
of the patients. 

Many games are amusing, and so far useful ; and these 
should be varied so that some should be intellectual, others 
social, and others physical. Dyspeptics are ever prone to dwell 
on their morbid sensations, and seem never to be so miserably 
happy as when relating the endless story of their sufferings to 
others, and especially to the physician. They should be led 
into other habits and out of this one ; for, unless the confirmed 
dyspeptic can be induced to think little and talk less of his bad 
feelings, the chance of ultimate recovery is small. 

There is a wide field for the exercise of discretion on the 
part of the medical adviser in managing dyspeptics ; and the 



MENTAL INFLUENCES. 147 

chief point of skill is to guide his intercourse with them so as 
to avoid depressing seriousness and irritating levity. His man. 
ner should always be positive and hopeful, without being dog- 
matic or flattering. There are no more suspicious persons un- 
der the sun than dyspeptics who feel themselves running down 
in spite of all the most nutritious food their weak stomachs can 
tolerate. If you look, talk and act with dignity and gravity, 
they imagine your prognosis is unfavorable ; while if you trea; 
their symptoms lightly, or do not give sufficient attention to 
their manifold distresses, and cannot satisfactorily explain all 
of their morbid sensations and utterly inexplicable nervousnesses, 
they are apt to think your diagnosis is at fault, or that you do 
not take proper interest in their case. 

The Hygienic physician (and no other ought ever to meddle 
with a confirmed dyspeptic), should give the patient one tho- 
rough examination ; listen with patience (if it has to be as- 
sumed for the occasion) to all he has to say, relevant or irrele- 
vant ; explain the nature of his case ; indicate its complications 
and their special causes ; give him the rationale of his leading 
symptoms ; tell him the plan of treatment to be pursued, and 
then instruct him to dismiss all thoughts of his condition and 
feelings, save when they are manifestly new or greatly aggra- 
vated, and give his whole mind and might to doing the things 
which make up the remedial plan. 

He should never talk nor think, if he can help it, about food 
while he is eating ; but take the quantity and quality that his 
judgment approves, and say to the stomach, " Peace, be still." 
Nor should he watch his sensations after meals, to see how 
the food agrees, for this is almost certain to make it disagree. 
" A merry heart doeth good like a medicine." Indeed it is 
medicinal in the hygienic and best sense of that word ; and 
happy is the physician, and blessed is the patient, when the 
judicious manner of the one, and the cheerful compliance of 
the other, render the recovery of health comparatively easy. 

The influence of imagination on the vital functions has 
always been recognized ; and it was this recognition that enabled 
the ancient physicians to be so successful with charms, amulets, 



1 48 DYSPEPSIA. 



and incarnations, as it enables thousands of persons at the pre- 
sent day to perform cures which seem very marvellous to those 
who do not understand the rationale. 

Plato taught that a person must have a natural disposition 
towards a thing if he would become that thing. It is most 
true that where the disposition dwells on an imaginary ailment, 
that ailment or some other will be the result of the mental in- 
fluence ; and true also, of the opposite mental state, when the 
mind dwells on anticipated health the doctor has much less to 
do. 

We should not be too hard on the quacks so long as the 
people "will have medicine." True, the medical profession 
ought to teach them the better way ; but as they do not, 
as invalids must have something to pin their faith to besides 
reason and common sense, and as the empirics are quite as 
safe as the regulars in their manner of dosing and materia 
medica, it would be a calamity to suppress them if we could, 
unless we could at the same time suppress the materia medica 
of the regular profession. 

Lord Bacon has said: "The imagination is next akin to 
miracle-working faith;" and that "It needeth a Delian diver 
rightly to pursue the study of the imagination in disease. " 
Edward Spencer, in the Atlantic, in an article entitled "A good 
word for Quacks, " remarks : 

" There is no doctor who would not rather contend with serious and even 
vital maladies, than with the thousand and one conceits and hypochondriacal 
fancies of the malade imaginaire, who, aggrieved by dyspepsia, and with 
his mind all awry, demands to be treated for every disease under heaven 
but the one mental lesion that makes him such a thorough nuisance. He 
has, indeed, no mortal malady ; but dees not his imagination give such as 
real and actual a twist to the nervous currents of his body as the magnet 
gives to the course of the compass ? It is a nervous condition like this — 
and all sickness is accompanied with more or less general disturbance of the 
nerves— that the doctor and the quack equally find their opportunity, and 
establish their prestige, by working upon the excited and despondent or 
expectant feelings. The force of sympathy, even, can work a miracle, if 
the mind be in this state." 



OCCUPATION. 149 



CHAPTER XXV. 
OCCUPATION. 

Useful, and, in many cases indispensable as may be the 
remedial measures treated of in the preceding chapters, there 
are many cases of invalidism in which occupation is the one 
thing needful. There are three classes of society, considered 
in reference to health, the working class proper, who have reg- 
ular vocations, but who can have needful leisure for recreation 
and education — the middle class ; the drudging class, who are 
toiled to death like beasts of burden prematurely, and the idle 
class. I need hardly say that the last two classes are abnormal- 
ities in sociology ; and it is difficult to say which is most to 
be pitied. It is hard to labor incessantly with no reward ex- 
cept just food, and raiment, and shelter enough to keep the 
muscles in working order ; no opportunity for mental improve- 
ment, and no hope of a better future in this life ; and this is 
the condition of more than one-half of the human race. But 
who knows the miseries of " upper tendom?" I am of the 
opinion that to rust and rot to death, or to die of dissipation, 
is quite as disagreeable, all things considered, as to be worked 
to death. The hopeless pauper may have few enjoyments ; but 
the great law of compensation does not make an exception in 
his case ; he is exempt from a thousand miseries that those who 
only live to eat, drink, dress, and enjoy the fruits of others' 
labors, suffer continually. Indeed, Gne can hardly walk 
through the thoroughfares of the world's great cities, and wit- 
ness the meretricious displays of what is called wealth and 
fashion, without a thought, if he is reflective, that one class of 
our people make themselves miserable in order to have other 
classes think that they are happy. There are thousands of 
beggars who would not exchange their "home" in some sti- 
fling attic, for palatial mansions, provided they were obliged to 
take the vexations, cares, sickness, doctors, nurses, and their 
attendant and inseparable disappointments. 



1 50 DYSPEPSIA. 



Invalids should have some occupation that is useful, and 
some object in life ; for it is the thing to be achieved in the 
distant though uncertain future that energizes the mind, invig- 
orates the body, gives persistence to effort, overcomes obstacles, 
and keeps mind and body in harmonious relations to each 
other. 

God and nature have so ordered the universe that one person 
can no more do another's work, without damage to both than 
one can do another's eating, or sleeping, or breathing. 

As dyspeptics are more prone to depression and melan- 
choly than most other classes of invalids, whatever can inspire 
hopefulness should be made available, if possible. Arid, valu- 
able as are gymnasia, games, plays, etc., there are many cases 
in which all together do not equal in remedial efficacy, any use- 
ful and healthful occupation I have many times wondered 
that, with so much surplus wealth in the land, and so much 
benevolence seeking expression and practical application, not a 
single dollar was ever given for such an institution as human 
society needs more than all others — an institution to provide 
health conditions, employment, and hygienic education and 
training for the sick and needy. 

Much is said, now- a days, of persons dying of overwork. 
But there was never a greater error. The Golden Age, in a 
recent issue, talked the right sentiments on this subject : 

" The newspapers never tire of preaching pleasant homilies on overwork. 
Gov. Geary died of that disease. So did Mr. Greeley. And so did Mr. 
Raymond. And so do hundreds of other men whose work the world wants, 
and whose wisdom and experience are sorely needed. We have committed 
the homily to memory, and can produce it with variations and illustrations 
whenever circumstances require us to talk without saying anything. But the 
plain truth is that not one man in a million dies from overwork alone. It 
is not the overwork, but working m unwise ways, without that care of vital 
mechanism which is absolutely necessary to keep it from wearing out at one 
point or breaking down at another, which does the mischief we so loudly 
deplore. One man kills himself by brain -work, because he is too indolent 
or stupid to balance the account by a proper amount of muscular exercise. 
Another kills himself by irregular habits, or exposures, or strains, or over- 
indulgence. Sometimes a working man steals an hour or two away from 
sleep every night, and is put to death for petit larceny. Sometimes a man 



OCCUPATION. 151 



dies because the sober cares of life have completely choked the laughter- 
valve of his nature and ten perish from excess of worry where one dies from 
excess of work. 

" The example ot Talleyrand, Napoleon, Brougham, Humboldt, not to 
mention other eminent toilers, goes to show that there is scarcely any limit 
to the amount of labor a man can do, provided that he will keep himself at 
the highest working condition, and use himself with the same wisdom and 
care with which he manages a valuable horse or a finely -constructed machine. 
If he will insist on compelling the animal he is bound up with to do two days' 
work in one day, or to strain himself by some terrible over-exertion, or to 
tug and toil in the harness until every particle of elasticity is lost and the 
possibility of recuperation is gone — if he will neglect the fine and delicate 
mechanism until friction wears it out in one place and rust eats it out in 
another, and dust clogs its joints and cinders cut through its nicely adjusted 
gearing — he must pay the penalty of his neglect in impaired power and a 
premature breaking down. It is not less labor that men want, but wiser 
methods of working, more varied occupation, better care, more frequent 
recuperation, and larger invoices of mirth and joy, with nobler incentives 
and hopes. We are satisfied that had Mr. Greeley given half the thought 
to caring for himself that he gave to the care of cattle, had he balanced his 
exacting brain-work with a corresponding physical exercise, if he had taken 
a daily bath of side-shaking and soul-expanding laughter, if instead of keep- 
ing one set of faculties pressed down upon the grindstone until they were 
ground clean away he had given each set its turn, he would doubtless have 
done more and better work and been alive to-day. And so of the other 
men whose premature departure is usually attributed to the same cause. 
It is not overwork but unwise working that kills. It is not less labor, but 
larger and wiser living that is needed to prolong life and enhance its results " 

On this overwritten subject of overwork, a late issue of the 
Saturday Review has some pertinent remarks : 

"Overwork is sometimes a simple appeal for compassion ; its supposed 
victim is merely acting the part of pallid student, to impress the audience at 
home. More frequently it is a delicate periphrasis for other evils of a less 
presentable nature. Its sufferer may be imputing to intellectual exertion 
what is really due to a misguided passion for supper-parties and to nights 
spent in devotion to loo. In short, overwork is a highly convenient veil to 
throw over the innumerable methods in which a youth may injure his con- 
stitution. If the physical mischief produced by excessive study could be 
fairly compared with the mischiefs produced by other causes, we have a 
shrewd suspicion that their sum total would be infinitely less than is gener- 
ally supposed. We may say pretty confidently, from a tolerably wide 
experience, that the number of victims to overwork is utterly insignificant 



152 DYSPEPSIA. 



compared with the number of victims from other causes, and with the num- 
ber of cases in which the excuse is imposed upon soft-hearted relations. 

" Business which keeps a man in a constant oscillation between ruin and 
a fortune, which follows him home and prevents him from sleeping, is incom- 
parably more trying than almost any quantity of downright steady work. 
The Stock Exchange, at New York, must fill lunatic asylums more quickly 
than all the most laborious Universities in Germany, England, and Amer- 
ica. A professor may labor at the collation of manuscripts, or even at the 
search for the absolute, for fifteen hours a day, and be all the better for it ; 
a third of the time spent in studying the ups and downs of Erie Railroad 
shares, and staking money on the result, would qualify him for a strait- 
waiscoat or a halter in a year. As, however, speculation has a compara- 
tively discreditable sound, the evils which it produces are very frequently 
placed to the account of its more respectable rival, straightforward indus- 
try. We choose, in one form or another, to spend a great part of our time 
at the gaming-tables which exist in an infinite variety of forms in every 
capital in the world, and then complacently complain that we have injured 
ourselves by over application to our duties. 

*• As a rule, therefore, we should say that the complaints of overwork 
are amongst the most flimsy of all the excuses set up by men for the evils 
which they bring upon themselves. Very few people really work hard ; 
and when they do it generally agrees with them. Directly or indirectly 
idleness does fifty times as much mischief, for the best cure for the love of 
excitement is steady application. A vast amount of good pity is thrown 
away in the world, and, instead of solemnly warning our friends not to do 
too much, we should find it simpler to refuse the indirect compliment for 
which they are maneuvering, and advise them to relax their minds by a 
little strenuous activity." 

Another very prevalent error is the notion that intellectual 
vigor and a pleasurable life are incompatible with the declin- 
ing period of life, or old age. The world is full of examples 
to the contrary, and all periods of history record them. Cor- 
naro became a broken down dyspeptic at forty ; but by adopt- 
ing a "sober and temperate life," enjoyed good health till 
nearly one hundred. 

It is said of Arnauld, the Jansenist, that he wished his friend 
Nicole to assist him in a new work. Nicole replied : "We 
are now old; is it not time to rest?" "Rest," exclaimed 
Arnauld, "have we not all eternity to rest in?" 

Dr. Samuel Miller says : "There is no doubt that the pre- 
mature dotage of many distinguished men has risen from their 



OCCUPATION. 153 



ceasing, in advanced life, to exert their faculties, under the 
impression that they were too old to engage in any new enter- 
prise. " 

When John Adams was 90 years of age he was asked how 
he kept the vigor of his faculties up to that great age. "He re- 
plied : "By constantly employing them; the mind of an old 
man is like an old horse ; if you would get any work out of it 
you must work it all the time. ' 

We have on record many remarkable instances of earnest 
and successful workers after they have passed into the period 
known as old age. 

Ecclesiastical history tells the story of Casidorus, who at the 
age of 70 retired to a monastery and devoted the remaining 
twenty years of his life to literature and religion ; and of Epi- 
phanius, who became an author at 64 and wrote several large 
works before his death. 

Between the ages of 58 and 6j Baxter wrote forty works ; 
after the age of 66 some of his most valuable works were writ- 
ten. 

1 ' The only remarkable thing, " says Hannah Mo|re, ' ' which 
belonged to me as an authoress, was that I had written eleven 
books after the age of sixty. " 

Says Lord Brougham, at the conclusion of his autobiography : 
" If any statements have been feebly and inaccurately rendered, 
it may be remembered that I began this attempt after I was 
eighty- three years of age, with enfeebled health, failing mem- 
ory, and but slight materials by me to assist it. 

Plato died at the age of eighty-one, it is said, with pen in 
hand ; and an account is given of another who wrote a history 
of his time at the age of one hundred and fifteen. 

William Cullen Byrant is a living example of mental and 
physical vigor, at nearly threescore and ten, equal to the best 
days of early manhood, because of a sober and temperate life, 
and, due attention to vital conditions while performing im- 
mense mental labor. 

Mrs. Sarah J. Hale, now eighty-five, is as entertaining (and 
more instructive) with her busy pen, as she was fifty years ago. 



154 DYSPEPSIA. 



It would not be difficult to name a hundred living persons 
of distinction who illustrate the principle that long life is con- 
sistent with great mental activity, and also with active and 
constant manual labor. But the final conclusion of the whole 
matter may be summed up in these words : Hard workers 
often live to be old ; idlers, seldom. 

In conclusion, I will add the testimony of my own personal 
experience ; which is this. Thirty years ago I adopted the 
mode of life recommended in this work ; and, although I have 
often felt obliged to labor inordinately, and have done much 
literary night-work, I have not, during the last thirty years, 
lost one day's work because of physical inability to do it, and 
have not at any time been in a mental condition that obliged 
me to decline literary work, when I have had time and oppor- 
tunity to do it. 



APPENDIX. 



The following article, written by request for a newspaper, 
which, however, refused to publish it because of its " radical- 
isms," is appended to this work, as being a true exposition of 
the case of Mr. Greeley, and as applicable to many similar cases 
which are continually occurring. The writer is morally certain 
that many valuable lives have been and may be saved, by 
adopting the plan of treatment which is mentioned as applicable 
to the case of Mr. Greeley. 

DEATH OF HORACE GREELEY. 

BY R. T. TRAXL, M.D. 

" Let us have peace " in the dying hour. When the would-be assassin 
of the late Governor Seward was called on to " report " himself at the 
gallows, and " be hung by the neck until he was dead," he was offered the 
customary brandy to support him through the terrible ordeal. "No," re- 
plied the condemned malefactor, " I intend to die sober." 

It is a horrible reflection on a false medical system, which mistakes the 
fever of stimulation for vital invigoration, that so few men of prominence in 
society are permitted to die in their "right mind." They are plied with 
stupefying narcotics, or delirium -inducing stimulants, until the brain reels 
and the recognitions become illusive, and finally, "the emancipated souls 
ascend to the bosom of their God " in a state of gibbering intoxication, or 
"dead" drunkenness. 

We rarely read of the medical treatment of any distinguished person, 
without brandy and morphine, or their equivalents, being among the lead- 
ing remedies. Precisely how this was with the late Horace Greeley we 
seem not likely to know, except inferentially, as the physicians who know 
the most about the matter, positively refuse to give any information except 
in vague generalities. Perhaps the people have no rights in this affair 
which the medical profession is bound to respect. But, it concerns the 



156 APPENDIX. 



living to know how Mr. Greeley was treated, and why he died. Can any 
one's life be safe if the doings of the doctors must be shrouded in mystery ? 
If the treatment of any given case will bear criticism, what have the doctors 
to fear? If it will not, the people ought to know why. Is not the suspi- 
cion legitimate that Mr. Greeley's physicians dare not submit their medica- 
tion to public judgment ? It may be argued that non professional persons 
are not proper judges. Granted ; but, cannot the learned physicians explain 
and defend ? 

I think it is not difficult to show that all of the professional opinions 
which were given of Mr. Greeley's disease were erroneous, and that all of 
the medication, so far as it lias been published, was worse than useless. In 
making this sweeping statement I wish it distinctly understood that I bring 
no charge against the integrity nor intelligence of his physicians. I im- 
peach the system, not the men. That being false, the treatment could not 
have been true ; for physicians, like other persons, must practice according 
to their theories. 

With regard to the diagnosis, we have five or six opinions from as many 
physicians: "acute mania," "inflammation of the brain," " paralysis of 
the brain," " hemiplegia," and " organic disease of the brain." The most 
eminent of the physicians who were called in consultation, were as contra- 
dictory in their opinions as they were celebrated for skill in just suck cases ! 
But, the history of the patient, and the causes and symptoms of the "ner- 
vous prostration," which all agreed was the essential condition, do not 
justify any one of the diagnoses. That Mr. Greeley had been excessively 
worked, and needed quiet, rest, sleep, is plain enough ; and this was the 
whole case. But, as he did not incline to sleep, he was drugged to stupe- 
faction, and therein was the fatal mistake. It was this first drugging that 
induced the subsequent alarming symptoms which so confounded the diag- 
nosis of the physicians. 

Nearly a year ago, the Prince of Wales was supposed to be dying. For 
several days he lay, as was supposed, at the point of death at Sandnngham ; 
and he was only saved by an incident which does not often happen under 
such circumstances— the discontinuance of the medicine. So long as the 
doses were swallowed, the symptoms continued alarming, and the accu- 
mulated doses finally occasioned so much "nervous prostration," that his 
four attending physicians, mistaking the effects of the medication for fatal 
complications, diagnosticated " goneness of one lung," and " perforation of 
the bowels." Had the illustrious patient been a politician instead of a 
prince, the doctors would probably have sought for the diagnoses in the 
head instead of the vitals, and doubtless have discovered as many impossi- 
ble things as were ascertained in the case of Mr. Greeley. But, fortunately 
for the Prince, Dr. Gull was called in consultation, and the treatment 
opportunely changed from "brandy and other stimulants," to milk. And 
the milk "acted" marvellously! In a few hours thereafter the patient 



APPENDIX. 157 



was convalescent, and in twenty -four hours was out of all danger. There 
are two theories extant in relation to this wonderful change. I shall only 
state them and leave the reader to his inferences. One is that milk, under 
certain peculiar and extraordinary circumstances, is a medicine of peculiar 
and extraordinary virtues ; and the other is that, as scon as the patient had 
eliminated the drug medicines he began to recover. Those who adopt the 
latter theory say that the patient was never in any danger, except of being 
drugged to death, as was his father in 1862. 

Humanity is naturally tough. Human beings do not die of over- 
worked brains, want of sleep, fatigue, or "nervous prostration." And 
Mr. Greeley was perhaps the last man in all this nation to be seriously dis- 
eased, much less to die because of political disappointment, domestic afflic- 
tion, losses of property, position, or friends. He was " a man of sorrows 
and acquainted with grief," as all true reformers and real philanthropists are. 
His great good heart, and mighty though sometimes erring head, were 
accustomed to pecuniary disasters, to bereavements that rive the soul, and 
he was familiar with both victories and defeats in moral, political, and social 
conflicts. Few men ever had a better preparatory education for all possible 
vicissitudes of fortune, and none ever more clearly realized or complacently 
contemplated the uncertainties of political controversies. That he worked 
hard for and earnestly desired to attain the highest position of honor and 
influence may be admitted. But, to suppose that failure maddened or in- 
flamed his brain and demoralized his whole nature, is simply absurd. He 
was fully aware of all that could possibly happen in the immediate future, 
and fully prepared for it. To talk of Horace Greeley dying of " presidency 
on the brain," though he might have been mistaken or unwise, or sicken- 
ing unto death because of the death of his wife — who had been dying of 
consumption for several years — is a libel on his name and fame. And add 
to these afflictions severe toil, night -watching, and the vexations of injudi- 
cious friends, selfish employees, and knavish and hypocritical associates, and 
still Horace Greeley was man enough to have endured the whole without 
dying. 

The elephant, whose prowess fears not all the animals of the forest, may 
be destroyed by an infinitesimal insect. A man of powerful body and giant 
mind may die of a single grain of poison or of medicine. If Horace Greeley, 
after the presidential campaign was decided, and his wife's remains had been 
deposited in the "city of the dead," could have had undisturbed quiet for 
a few days, he would, in all human probability, before this time have re- 
sumed his proper place and sphere as editor of the Tribune. 

The effects of prolonged watchfulness, excessive labor of body and mind, 
disappointed ambition, and personal grievances (and these are all the ele- 
ments of the case), are, accumulation of blood in the brain, constituting 
cerebral congestion, and deficiency of blood in the surface and extremities. 
This general condition of unbalanced circulation is evinced by hot head or 



ATTENDIX. 



pain in the head, with cold feet, rendering the patient sleepless, irritable, and 
semi-delirious. A little aggravation of this congestion would render the 
patient apoplectic; but there is nothing in this condition or in the attend- 
ing symptoms, taken as a whole, on which to predicate "mania," inflam- 
mation," or "paralysis." Dyspeptics very frequently have a similar con- 
dition, with every one of Mr. Greeley's symptoms, for months, and yet recov- 
er. It is not unfrequent for dyspeptics who are not seriously, certainly not 
dangerously sick, to sleep so little and so fitfully that they imagine they do 
noi .sleep at all. 

The medication that Mr. Greeley needed was simply hygienic. I think 
any competent nurse, left to his or her wits, without the aid or interference 
of physicians, would have cured the patient. If he had been left to him- 
self, and all visitors kept away, he would in due time have slept from shear 
exhaustion, as patients do after a severe fever. And the sleep would have 
saved him, as it does them, when they are not annoyed by attendants. This 
is nature's method of balancing the circulation and restoring " the normal 
play of all the functions." It is a mistaken pathology that is always seek- 
ing the cause of deranged vital functions in paralysis or other affections of 
the brain. The brain is the most vitalized structure of the whole system, 
and cannot be paralyzed. 

The following plan of treatment would have been proper for Mr. Greeley, 
and has been invariably successful in similar cases, in the hands of Hygienic 
physicians : He should have had a warm bath, just prolonged enough to 
bring the blood well to the surface, and then put to bed in a quiet, well- 
lighted and well- ventilated room, of an even and agreeable temperature. 
His feet should have been kept constantly warm with bottles of hot water, 
bags of sand, heated bricks, or something similar. So long as the head was 
hot and painful a cool wet cloth should have been applied to the forehead 
and face, covering the eyes so as to favor sleep. If the head was affected 
at any time with neuralgic or intermitting pains, without heat, warm wet 
cloths (fomentations) should have been applied until relief was obtained, 
and then the cool wet cloth resumed. All visitors should have been excluded. 
Nothing is more pernicious in such cases than meddlesome attentions, 
the constant calls of friends and neighbors, frequent interviewings of report- 
ers, constant quizzing of curiosity -seekers, and perpetual examinations of 
physicians in watching the ever-changing phases of the multitudinous 
diagnoses. Mr. Greeley had enough of these annoyances to account for the 
" taking off," to say nothing of the abominable drugging. He should not 
have had but a single watcher, lest whispering might disturb him, and 
even that watcher should have occupied an adjacent apartment — never the 
same room ; for in such cases of " extreme nervous prostration," the mere 
presence of another in the room may prevent the all-important sleep. 

How different was the management in Mr. Greeley's case ! The physi- 
cians would let him have no peace. Friends and neighbors were annoying 



APPENDIX. 159 



him continually. lie was transported "from pillar to post ;" and tested 
and experimented on till the last breath. "Did he know this person?" 
"Could he recognize Mr. Weed ?" Did he know he was insane ? Was 
he conscious of mania or paraly sis ? The two latter questions were proba- 
bly not asked, but they are no more absurd than those which were asked. 
No wonder the tormented sufferer lost all power of normal recognition, and 
could only gibber incoherent phrases as one does in delirium tremens : "I 
died when I was born, and was bom when I died." Left to himself, I 
repeat, Horace Greeley would have slept ; and if his sleeping had not been 
disturbed^ as it should not have been, he would in due time have awakened, 
and then, if his vital organs had been so exhausted that death was inevitable, 
he would have entered the dark valley of the shadowy land, in the full 
possession and use of every power and faculty of the immortal mind, as all 
persons do who die a " natural death." 

The doctors did indeed recognize the maxim, "sleep or death," as 
applicable to Mr. Greeley's case. And now let us see how they tried to 
put him to sleep. Dr. Krackowizer, who first took the patient in hand, gave 
him, according to the Philadelphia Press, "energetic" treatment. The 
New York Sun of Dec. 6, tells us that this energetic treatment consisted of 
thirty grains of bromide of potassium daily. Verily it was energetic. Dr. 
Krackowizer claims that this was a moderate dose. Let us see what the 
highest authority {United States Dispensatory, page 1 152) says of this drug : 
" When given in large doses (five drachms daily) M. Rames found it to 
produce a peculiar intoxication, attended with torpor and drowsiness. In 
one case this condition was attended by an insensibility so complete that 
the puncture of the skin with a suture needle was not felt, and the titillation 
of the conjunctiva and fauces with a feather produced neither winking nor 
a desire to vomit." 

Dr. Krackowizer says the patient was more quiet for several hours after 
taking the first dose. No doubt. But it was the quiet of apoplectic stupor, 
instead of the quiet of recuperating sleep. All of the salts of potassium, 
(nitre, tartar emetic, etc.) are among the most debilitating agents of the 
materia medica. A few grains too many, administered in a single dose, 
have frequently occasioned death. True, many persons can bear, without 
dying, and without appreciable stupor, many times the quantity that Mr. 
Greeley is reputed to have taken. But in his condition of extreme nervous 
prostration, a small dose of an extremely depressing medicine may have 
had a great effect. 

Dr. Hammond thought the treatment should have been just the reverse 
— stimulation. The celebrated Dr. Brown-Sequard, from Paris, who didrft 
"cure the Hon. Charles Sumner," thought Mr. Greeley had "paralysis of 
the base and top brain." Dr. Hammond said this could not possibly have 
been the case ; and in his opinion the disease was just the opposite — "in- 
flammation of the membranes and cortical substance. " Dr. Brown-Sequard 



l6o APPENDIX. 



said that one side of Mr. Greeley was paralyzed. Dr. Hammond states 
that this was not the ease. Dr Choate, who had the patient in his house 
for several days, refuses to say anything about the manner in which he 
treated him. Dr. Brown, of Bloomingdale Asylum, refused to tell the Sun 
reporter anything definite. And is this all the people are to know of Mr. 
Greeley's sickness and treatment from his five physicians ? Perhaps it is 
none of the people's business Possibly it may be altogether a private affair 
between the disagreeing doctors and the unfortunate patient. But the cir- 
cumstances are vividly suggestive of the inquiry, whether society exists for 
the benefit of the medical profession, or whether the medical profession 
should exist for the benefit of society ? 

There is one other view of this case which concerns all persons who are 
liable to fall into the hands of the physicians. It is the usual, almost uni- 
versal practice of the medical profession, to give persons m Mr. Greeley's 
condition, and all patients who are feeble or prostrated, alcoholic stimulants. 
Indeed, stimulation and alcohol have come to be very nearly correlative 
terms Dr Hammond thought stimulants should have been administered 
to Mr Greeley instead of bromide of potassium. Perhaps they were by the 
other physicians, who keep their own secrets Be this as it may, there is a 
fatal delusion abroad on this subject of alcoholic medication To Mr. 
Greeley it was of no sort of consequence whether he took the recognized 
stimulant or the admitted depressant. Each is equally life exhausting. 
The stimulation of alcohol is nothing more nor less than a feverish disturb- 
ance, which has been mistaken for "supporting vitality." Alcoholic 
medicines are almost universally prescribed, because they augment the heat 
of the body and increase the circulation of the blood. But the truth is, 
they do not do it. They simply occasion a disturbance of circulation and 
temperature, and so does bromide of potassium. After a dose of alcohol 
some parts of the body will be wanner and others colder (as in all fevers), 
and some organs will have more circulation and others less (as in all fevers 
also). But the sum total of circulation and temperature is actually dimin- 
ished, as in all febrile diseases. It is time this matter was understood by 
physicians, and they would understand it if they would look at the facts on 
record without prejudice. Dr. B. W. Richardson, of London, has demon- 
strated, by a series of careful and elaborate experiments, that all forms of 
alcoholic liquors are just the reverse of stimulants, so far as the whole force 
of the circulation, and the whole amount of animal temperature are con- 
cerned. Directly or indirectly they waste vital power, as every other poi- 
son does, whether the person who swallows it is sick or well. Hygienic 
physicians never administer stimulants in cases of debility, prostration, or 
" running down " after fevers, and that is one of the principal reasons why 
their patients so generally recover. 



i < 



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